Aesthetic proportions of the lips and their effect on facial attractiveness are poorly defined. Perioral aging is highly individual with several distinct processes taking part simultaneously and can be broken down into changes of the lip shape and changes of the lip surface. The aging processes can act on lip volume and length, lip shape and degree of vermilion inversion. However, existing data about perioral aging has not yet been transformed into a consistent therapeutic concept which helps to indicate the right rejuvenation approach among the multitude of treatments. The aim of this study is to analyze the parameters that make lips attractive, developing specific guidelines for achieving a natural look. In this study, we evaluated four specific parameters: philtrum height, upper vermillion height, ratio between philtrum and upper vermillion height, golden ratio between upper and lower vermillion height. The analyses of these four parameters allows a numeric definition of the lips. This new classification and its associated analytical guidelines allow accurate diagnosis and can also simplify the explanation of the treatment to patients. There is no single prescription for a “perfect” lips, and treatment should be tailored to each patient’s individual needs. For this reason, these guidelines may help practitioners in customizing the proper lip treatment for each patient and achieve “ideal lips” based on specific and measurable characteristic of the labial area.
Prof. Sito received his medical degree from the University of Naples in 1978. He completed his training through Specializations in Emergency Surgery (Naples), Urology (Rome) and Endocrine Surgery (Naples). He is a full professor in Anatomy at Luigi Vanvitelli University of Naples and Scientific Director at Pegaso University in Aesthetic Medicine Masters. He is also a member of the Italian Society of Plastic and Aesthetic Surgery and he is an author of many books concerning Plastic Surgery and Aesthetic Medicine and has published more than 100 scientific papers in Italian and foreign journals.
The many and varied options for repairing a cutaneous defect can be a challenging decision pathway for the novice surgeon, dermatologist or GP. For the experienced plastic surgeon with decades of reconstructive practice, the choices are often simply automatic. This is based on many cases, of trial and error, or success and failure, of restoring anatomical repair initially and then refining this into aesthetic reconstruction. Some years ago my senior mentor at Middlemore Hospital in Auckland, New Zealand helped me as a novice trainee understand the classification of local flaps based on how they moved to close the defect by either advancement, movement about a pivot point (rotation / transposition) or a combination of these movements. This introduction to local flaps evolved into an atlas defining local flaps in all the common clinical applications of local flaps. Local flap methods are based on historical principles which are fundamental and intuitive. Sometimes based on surgeon experience, a split skin graft or full thickness skin graft including the composite graft suit the repair options better. We have also learnt to apply methods used in aesthetic or cosmetic surgery for reconstructive challenges and have defined this under the concept of aesthetic. Three plastic surgeons with a combined collective experience of over 100 years collaborated over a two year period to produce a local flap guide for trainees and consultant plastic surgeons, which we titled Simply Local Flaps. We believe this will help answer the question: to graft or to flap?
Michael Klaassen studied medicine at Otago University in Dunedin and graduated MBChB in 1980. He had extensive and varied training in many surgical disciplines before qualifying FRACS(Plast) in 1990. He has worked in the UK, Australia and New Zealand. He has been a trainee selector, supervisor and mentor as well as an examiner in Plastic & Reconstructive Surgery with the RACS and a volunteer surgeon/tutor with Interplast Australia & NZ. In the last year, he has published three books on plastic surgery including The Congruent Facelift, Simply Local Flaps and An Examiner’s Guide to Professional Plastic Surgery Exams.
Vegan Skin by Paul Joseph is an all natural, plant-based, e-commerce, skincare, company that specializes in healing and hydrating the skin and scalp. Founder and C.E.O. Paul Joseph Griffith was diagnosed with a rare, autoimmune, skin, disease known as Hidradenitis Suppurativa when he was 23 years old. There is no known clinical cure or effective treatment for the disease. It is also degenerative and believed to affect approximately 1-2% of the American population and possibly globally. Throughout his formative years, the disease progressed and eventually spread across half of his body. He was covered in boils from the waist to his ankles and contemplated ending his own life. He decided in that moment to figure out a solution for himself driven by the research question, “How did our ancestors take care of themselves before modern medicine and technology?” Armed with this driving question, for four years he researched the healing properties of plants, focusing on their microbiology, and created three, signature, products for the skin and scalp. The products assisted in his healing and as a result became popular amongst friends and family members. Before long, the products became popular amongst customers across America with reports of assisted healing with autoimmune diseases such as eczema, psoriasis, dermatitis, folliculitis, cystic acne, chronically dry skin, rashes, and more. Thus, the focus of the oral presentation will be the intersection of the following: 1. The power of self—healing 2. The market for plant—based, natural, and wholistic solutions for skin and health 3. Plant microbiome and autoimmune disease treatment
Paul Joseph Griffith has completed his Masters at Tufts University, serves as the C.E.O. of Vegan Skin by Paul Joseph, is a part-time professional dancer, a former public high school teacher and lives a busy vegan lifestyle in Washington D.C., U.S.A.
I forward an observational case, I think the first case in the world, of a bedsore healed through exosomes from fat derived stem cells of homologous-allogenic origin, i.e. from a relative of the affected patient(!!). Having been dealing since many years with healing of trauma and burn wounds by adipose tissue transferred from patient himself (autologous fat transfer), I have had the occasion to treat a bedsore (skin ulcer due to compession) by a new method. It was a chance, and it worked. Through a Swiss stem cell factory which developed exosomes from ADSC (adipose derived stem cells), I had the opportunity to treat the bedsore of a woman with exosomes from ADSC of her husband, achieving a resolution in few days after some months of unsuccessful traditional plastic surgery care. It was a chanche based on well established references on the matter of homolous effectiveness of exosomes from MSC (mesenchimal stem cells). The aimed success of the procedure, always in condition of safety for the patient who was throughout informed on it, was achieved. Presently, it is only a single case report, but it should be of some use in order to overcome and go over the present condition of believe . I could seem to have faced a risky business, especially for the present absence of guidelines on homologous use of microvescicles from MSC, but in the present case report the homologous ADSC exosomes were applied topically (never injected) with no risk of general worsening of the whole body health of the patient, and the patient was checked every day. No special purpose is the aim of this observational case report , other than a suggestion for further studies on large number of patients after having well established preclinical evaluation. I think , in the present absence of specific guidelines on the use of microvescicles from homologous origin, that a peer to peer commission and a consensus conference would be set up, in order to avoid every attempt to forward a “miracle therapy” and every “pirate business” , but also to deliver to clinical use a safe and clever way to treat wounds. This observational case report was only a chance that was offered to the patient and to medical researchers, and because I happened to be in the right place at the right moment, I tried and I succeeded. A future deep interest from researchers should be devoted to the healing effect , even if made easy and supported by homing to affected and inflammed target tissue, in terms of a suggested (but not proven) induction by ADSC derived exosomes to any of the three germ layers derived stem cells, or in terms of a simple but important antinflammatory effect of these microvescicles on mesodermal layer only which then improves the whole bulk of affected tissue. In my point of view, only an improvement in antinflammatory potential of local tissue has happened, but this regenerative potential can be a new item in the neverending history of medical matter. It could work also on wounds from war fields and from car traumas and in burns and in the loss of tissue (especially for its clear antinflammatory potential)..and it means that fat tissue is farmost more important , and easy and less expensive to harvest, than bone marrow (..to say nothing on the importance of homologous tissue other than autologous tissue!!!). There had been a stop in the research trial becuse of items (maybe of economic business I don't know). The evidence of a business interest in this matter, should never make go lost the foremost importance of ethical issues connected with this homologous use of fat. Anyway, I have had the opportunity to observe this first case and I can witness it through the patient itself. As an observational case report it comes from bedside to bench but, I hope for researchers, then from bench to bedside in future.
Prof Erri Cippini got the Degree in Medicine and Surgery at Milan University (Italy) on 18.12.1981 with full marks and honour (110 cum Laude) and he won also the award for the best student with the highest marks during his fifth year of the sixth year academic duration Degree. Prof Cippini completed a full Residency program in Ob/Gyn at Milan University (Italy) and ten years experience in Oncology Gynecology at the University Hospital of Brescia (Italy) that progressively evolved towards Reconstructive Plastic Surgery after cancer and malformations, with special interest in Face Breast Abdomen (also Bariatric Surgery) and Female Genitalia that addressed him to a second full certified Residency in Plastic Reconstructive and Cosmetic Surgery at the same Milan University. In July 1990 he got the ECFMG certification (USA), then GMC (UK) certification also in the Specialist Register as Plastic Surgeon since February 2009, moreover FMH certification (Switzerland) both for Medical Degree and Plastic Surgery with licence to practice since 13 August 2009. Enrolled (one of fifteen Italian doctors) on 30 October 2012 in an international (European) study protocol on Azzalure (botulinum toxin A) from Galderma. Former Scientific director of a swiss settled Foundation on evolutive procedures for treatment of human ailments, with the first observational case of bedsore (pressure ulcer) resolved (under personal suggestion) with exosomes of mesenchimal stem cells from homologous-allogenic adipose tissue. Professor chief of Plastic Surgery Teaching Program (from yr 2006/2007 to yr 2010/2011 which is the complete duration of the program) at the University of Brescia, Faculty of Medicine and Surgery, for the Course Degree in Medical Biotechnology and former instructor of Anatomy at the Medicine Faculty of the same University
Sunscreen application is a common strategy used to prevent the damage induced by UV radiations. In the last 30 years a variety of protective agents against UV exposure have been developed: physical filters, chemical filters and organic filters. Physical filters are the safest: they scatter and reflect UV rays, but are difficult to apply on the skin. Chemical filters are capable of absorbing these rays, they are cosmetically pleasant, but recent studies suggest a toxicological nature for some of these agents. Organic filters are the newest advance in sun products . Since 2003 the COLIPA Index (Europe) has regulated sun product availability on the market. In the USA, the FDA establishes the classification and the safety of sun products, which are considered topical medical drugs. This topic summarizes the dermatologists point of view, according to the patients request, professional ethics and increasing offer of sun product.
Dr. Antonina Agolzer is an MD dermatologist since 1991. She obtained a degree in medicine and surgery (full score "cum laude") at the University of Trieste, where she continued her studies obtaining a second degree in dermatology and venereology with the full score "cum laude". During the university she had experiences at the Allgemeines Krankenhaus of Wien and at the Freie Universitat of Berlin. She has worked many years as a dermatologist in the Italian public system. She is now working for over 20 years in private praxis. Fields of interest are dermoscopy, aesthetic and corrective dermatology, trichology, pediatric dermatology, nutrition as therapy in a global holistic approach toward patients. She speaks in many medical congresses, she writes many publications, she organizes dermatological courses with the scientific societies DDI, ISPLAD, AIDA. Her mother tongue is Italian but also German and English very good spoken too. In 2003 she founded a private cultural association which promotes the correct behavior with the exposure to UVA rays. This long work of information and student-screening in the schools gave her the possibility to obtain in December 2014 the prestigious award "Donna di fiori nella Ricerca" in Gorizia, Italy.
Modern aesthetic rejuvenation techniques using fillers allow an optimal volume restoration in the face. Neck rejuvenation, on the contrary, remains a challenge for aesthetic physicians. The current filling techniques approach the neck as a flat surface, treated only in the antero-lateral portion.Aim of this study was to demonstrate that treating neck circumferentially, using fillers and biomimetic peptides on a 3D-vision, can produce a better lifting effect. Eleven patients with a mean age of 53 years, refusing or trying to delay neck lift surgery, underwent 3D circumferential non surgical rejuvenation technique. High cross-linked hyaluronic acid (HA) was injected posteriorly, volumizing HA was injected behind and in front the lower part of both ears; anterior subcutaneous area of the neck was treated with low cross-linked HA. Biomimetic Technique was well tolerated by all patients. In all cases a moderate to mild improvement of cervico-mental angle (CMA) and a decisive lifting effect in the lower two-third of anterior portion of the the neck were observed. No early and late significant complications occurred. conclusion, 3D injective technique is a novel, safe and effective method for non surgical neck lifting using fillers. Proper patients selection is crucial for success of this technique.
Dr. Annalisa Calisti is the regional coordinator of Italian Society of Aesthetic Medicine in Lazio, Italy. She is a specialist of aesthetic treatment of the neck and created a new technique for non surgical neck rejuvenation. She graduated from Rome with honors in 1995 and is specialized at "La Sapienza" Rome University with honors in 2000. She specialized in Cosmetic Medicine in Rome from 2010 with honors. She has several publications in national and international indexed medical and surgical journals. She lectures nationally and internationally and she is a faculty at AMERICAN (American aesthetic association) for "aesthetic phlebology"
Effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the art of medicine. This is important in the delivery of high-quality health care. Much patient complaints are due to breakdown in the doctor-patient relationship. Doctor-patient communication is a major component of the process of health care. Doctors with better communication and interpersonal skills are able to detect problems earlier, can prevent medical crises and expensive intervention, and provide better support to their patients. The above concepts and facts will be discussed in a short oral presentation.
Eman Mekkawy a Dermato-Venereology Specialist. Head of Department of Dermatology and Aesthetic Dermatology in Golf hospital in Cairo. She was born in 1973 and graduated from Kasr El- Aini Medical School, Cairo University, in 1997. She achieved Degree in Dermatology & Venereology from Faculty of medicine–Al-Azhar University-Egypt in 2011. She achieved diploma of Aesthetic Medicine & Laser from American Academy of Continuing Medical Education. Currently she is owner and manager of Dr. Eman Mekkawy Clinics based in Cairo. Her practical interests include Aesthetic Dermatology, Dermoscopy, Antiageing & Professional Business. She is Story writer and artist.
Aging is a continuous process and it sets in since second decade of life .Various factors play important role when and how aging takes place in a particualr individual.Factors liike genetics , ethnicity , effect of sun damage , pollution , stress and gravity would play a major role in deciding dynamic changes that take place over the face. It widely varies from individual to individual and also differs on one side of face compared to other half.Soft tissue fillers have evolved from animal derived collagen to arficially poly-L-lactic acid, calcium hydroxylapatite and hyaluronic acid and also different grafts.Those substance not only does a filling effect but it also allows body to syntesise its own collagen hence helps in lifting the face and supports against gravity.soft tissue fillerss have been used to restore the volume in majority of the area of face and it also helps in enhancing face features by non surgical means. Fillers being a part of minimally-non invasive of medical science would allow aesthetic physician to scupt the face along with botulinum toxins and autologus fat with minimal downtime compared to surgery. Complications associated with soft tissue fillers included tissuenecrosis, inflammatory nodules, hypersensitivity reaction, and blindness and cerebral ischemia.Learning curve for filller is semi steep but the complication would be dreaded as its a blind procedure, however sound anatomical knowlede and using cannulas and needles alternatively depending upon the comfort of the clinician would help minimising complications.
Dr. Malay Mehta has completed MD Dermatology in 2014. Inclination towards cosmetic dermatology has brought him to Mumbai and started his career with biggest chain clinic in dermatology as a consultant. He opted to go for observer fellowship in McGill University, Canada and Vanderbilt University, the USA to sharpen his clinical and cosmetic dermatology. Since over a year he had established himself as a celebrity dermatologist in Mumbai and heading a clinic " Marvel Skin and Hair Clinic". Had presented papers and posters in nationals and International conferences. Had 5 publication in pubmed index journals.
Burns, are characterized by injury progression due to reduced dermal microcirculation, inflammation, and oxidative stress. A previous study rat comb burns demonstrated that tadalafil, a phosphodiesterase 5 inhibitor used as a vasodilator to treat erectile dysfunction, reduces burn injury progression. In this study, we tested whether tadalafil speeds reepithelialization and reduces scarring of deep partial thickness burns in a validated vertical progression porcine burn model. We created 60 deep partial thickness burns on the backs and flanks of six anesthetized pigs using an aluminum bar preheated to 80 degrees C for 20 seconds. The pigs were randomly treated with 2.5mg oral tadalafil or a placebo within one hour of injury and once daily thereafter for six days. Periodic imaging and full thickness biopsies were conducted to monitor healing over 28 days. The mean (SD) percentage wound reepithelialization of burns treated with tadalafil (n=60) and control (n=60) at days 15 and 18 were 91.6 (25.4)% vs 43.5 (43.8)% and 96.4 (15.8)% vs 75.7 (38.7)% (p<0.001 for both). The median (IQR) time to complete wound reepithelialization was a significant 3 days faster in burns treated with tadalafil, at 15 (15-15) vs 18 (15-28) days, p<0.001. After 28 days, scar depth was significantly less in burns treated with tadalafil (2.7+0.4 vs 3.7+0.6mm, p =0.005). There were no wound infections or systemic adverse events in any of the wounds or animals respectively. We conclude that once daily treatments of oral tadalafil speeds reepithelialization and reduces scarring in porcine deep partial thickness burns.
Adam Singer has completed his MD from Ben-Gurion University, Israel and a residency in Emergency Medicine at Stony Brook University, USA. He is the Vice Chairman for Research in the Department of Emergency Medicine at Stony Brook. He has published more than 400 papers in reputed journals and has been serving as an editorial board member of repute.
Plasma, the 4th state of matter influences our life’s in many ways. It is visually all around us in many forms from manmade devices to naturally occurring phenomena. Its advantages to the medical sector are now becoming more apparent. Devices in this sector vary from simple corona discharge to the more advanced pure gas derived generation. In all cases there are unique contributing factors. • Corona discharge ( electrostatic) generally burns small circles into the skin via the arc produced between the hand piece and patient • Nitrogen Plasma • Argon Plasma • Helium Plasma Pressurized gas derived plasmas are all non-chromophore dependent, none ablative and suffer from considerably less complications than the laser devices they are intended to replace. Interestingly all gas derived plasma also improves absorption of topical drugs into the skin to aid in the treatment and management of many dermatological conditions although at different levels. These gases can be ionised by differing methods with differing levels of success. Cold plasma such as those derived from the argon and Helium are proving excellent at treating of wounds and in some cases bacterial infections. Nitrogen Plasma released from the hand piece in microsecond burst and beyond atmospheric pressure purges the combustible gases from the treatment area allowing controlled heating of the tissues without burning or charring and is proving excellent in the treatment of acne, clearing of precancerous legions, denaturing of bacteria and fungus as well as many more skin conditions and anti-aging indications. An exciting consequence of all these advantages is that plasma in most forms can be used safely on all skin types.
Born 1961 in Manchester UK. Attended Blue coat school and then Moston Aeronautical College while serving an Engineering Apprenticeship at British Aerospace. Work on several aircraft types both civil and military before specializing on Airbus Wings. Continued to work on Aircraft, CNC Programming, CAD design and manufacture until 2000 in the UK and Netherlands. In 2000 I became interested in Medical device design and manufacture and started my own company, manufacturing in Eastern Europe and then Indonesia for distribution in the EU and Asia. To assist in design I studied Physiology which assisted me greatly in design of product for the Rehabilitation, electrotherapy, spinal injury, exoskeleton and functional electro stimulation. Sale of the company in 2012 finally led me in to Aesthetic systems in 2014. I am now the Energist group sales director for Asia, Oceania and the Middle East as well as developing Canada and the product champion for NeoGen.
Approximately 25% of melanoma patients with locoregional metastases are nonresponsive to new molecular target therapy and immunotherapy. When metastases are located in the pelvis, melphalan hypoxic perfusion can be an optional treatment. Because methylation of MGMT promoter increases the efficacy of alkylating agents, studies on melanoma outcome of patients treated with melphalan regional chemotherapy should consider this epigenetic change. This study aims to evaluate whether the survival of stage III melanoma patients treated with melphalan regional chemotherapy may be correlated with MGMT methylation status. The metastatic tissues of 27 stage III melanoma patients with locoregional metastases located in the pelvis subjected to melphalan hypoxic pelvic perfusion were examined. The methylation status of the MGMT promoter was investigated by MS-MLPA probes analysis and the presence of the BRAF V600E mutation was analyzed by CAST-PCR. The median survival times were estimated using the Kaplan–Meier curves and were stratified according to the clinicopathological characteristics of patients and lesions. The overall median survival time was 17 months. The 1-year, 3-year, and 5-year survival rates were 66.7, 18.5, and 7.4%, respectively. Disease stage, burden, and percentage of MGMT methylation significantly affected survival. We estimated an MGMT promoter methylation cut-off of at least 14%, which was significantly associated with a longer survival after melphalan regional chemotherapy. Our data suggest that MGMT promoter methylation could be an important factor in determining which melanoma patients should receive melphalan regional chemotherapy, but its prognostic significance in the routine clinical setting needs to be clarified in a larger study.
Stefano GUADAGNI was borne in 1955 and is Associate Professor of Surgery at University of L’Aquila , Italy. He has published more than 170 original articles in reputed journals and is serving as an editorial board member of two Journals indexed by Scopus: BMC Research Notes and World Journal Surgical Oncology
Involving using of human stem cells in Androgentic Alopecia that holds a great promise. There are numerous sources of autologous human stem cells being used for the treatment for AGA. A recent new discovery source of autologous human stem cells is harvested from human hair follicles. Hair follicles are known to contain a well-characterized niche for adult stem cells: Mesenchymal stem cells in the dermal sheath and the bulge, which contains epithelial and melanocytic stem cells. Stem cells in the hair bulge, a clearly demarcated structure within the lower permanent portion of hair follicles, can generate the interfollicular epidermis, hair follicle structures, and sebaceous glands. A new method to isolate human adult stem cells by mechanical centrifugation of punch biopsy from human hair follicles without culture condition. Area of punch biopsy at the mastoid process along the hair line demarcation bilaterally. Human follicle stem cells (HFSCs) is used, to improve the hair density in patients affected by Androgenetic Alopecia AGA in stage 2–5 as determined by the Norwood-Hamilton classification scale and few cases of Alopecia Areata. It has shown that the isolated cells are capable to improve the hair density in patients affected by androgenetic alopecia (AGA) and in some cases of Alopecia Areata.
Dr Kelvin Tan was raised up in Auckland, New Zealand and completed high school and college in New Zealand. Dr Kelvin obtained his Medical Degree (MBBS) from Kasturba Medical College in 2007.He is specialized in Hair Restoration and Hair line reconstruction. Then he pursued further in Fellowship and Board Certification of Anti-Aging & Regenerative Medicine in USA and other Aesthetic Medicine Qualifications in USA & South Korea. Dr Kelvin is currently the Founder and Medical Director of Elegant Clinic Malaysia and he has been practicing medicine since 2008. He has worked as an Independent Consultant and Aesthetic Physician at Dermatology Centre or 4 and half years, Mahkota Medical Centre, a Multidisciplinary Specialist Hospital in the southern city of Melaka, Malaysia. He is the PRP (Regenlab) Key Leader Opinion (KOLs) and Certified Trainer in Asia pacific (Regenlab) in Hair loss treatment and skin rejuvenation. He is also the KOL and Trainer for Neauvia biostimulate fillers. He is also the Future Leader for Juvederm, Allergan Medical Institute (AMI).
The barrier system of the skin not only defends against antigens and harmful substances, but also hinders the permeation of medicines and cosmetics into the dermis. Several strategies have been developed to enhance the absorption ability of skin, including the use of chemicals and skin ablation devices. However, the cost and inconvenience of these strategies highlights the need for a novel and safe method for increasing skin absorption. In this study, we examined the effect of non-thermal plasma (NTP) on the efﬁciency of drug penetration through the skin, as well as its mechanism of action. HaCaT human keratinocytes and hairless mice were exposed to NTP treatment, and the cellular and tissue gene expression, and morphological changes were monitored. We found that the NTP exposure reduced the expression of E-cadherin in skin cells and led to the loss of cell–cell contacts. The exposure of mouse skin to NTP also reduced the expression of E-cadherin and prevented intercellular junction formation within the tissue, leading to enhanced absorption of hydrophilic agents, eosin and epidermal growth factor. The reduction in E-cadherin expression and reduced skin barrier function recovered completely within 3 hours of NTP exposure. Taken together, these data show that NTP can induce a temporal decrease in the skin barrier function by regulating E-cadherin-mediated intercellular interactions, leading to the enhanced transdermal delivery of drugs and cosmetics
Gyoo-Cheon Kim had a PhD degree from Pusan National University in 2001. Since 2004, he has been a professor of School of Dentistry, Pusan National University. As one of pioneers in the field of plasma medicine, he has introduced various plasma application technology in reputed jurnals and holds more 25 patents. Based on his work, he established a venture company called FEAGLE, a company developing plasma medical devices.
Statement of the Problem: Dynamic and static wrinkles and lines treatments have always been one of biggest challenges in Aesthetic Medicine because of poor , temporary and short term of results , It seems filling threads will be a great alternative therapy for these but the problem is doctors have not enough knowledge , experience and skill about this very new and progressive procedure . We have been working on these threads in Iran over 4 years and at this period of time we go through this procedure based on survey on hundreds of our patients in Iran and recently in Turkey. Wrinkles like crow,s feet make the person many years older meanwhile , satisfaction rate of our patients was over 90 % , they look many years younger ! These threads are absorbable, made of PDO (Polydiaxanone) that remains 3-6 months and stimulate tissue reaction. Effects will be remain 1-2 years .There are new generations of threads that generally longer lasting than PDO called PLLA (poly-L-lactic acid) that remains 6-9 months and PCL (polycaprolactone) that wonderfully remaines 2 years! With this very long lasting effect of PCL it is a big revolution in rejuvenation methods. Conclusion & Significance: Filling threads are extraordinary and astonishing alternative therapy for wrinkles and lines of the skin but it needs experienced and skilled doctor, complications are very few and results are long lasting, miraculous and satisfying. I am going to share, this impressive experience with my other colleagues.
Dr. Afshin Javili, an Iranian doctor, is a Cosmetic Surgeon and ENT Specialist. He is a medical doctor from Tehran University of Medical Science (1997), ENT Specialist from O.O.Bogomolets National Medical University (NMU) Kiev Ukraine (2009). Since 2012 he has been working on Non-Surgical Aesthetic Procedures, he has gone through these procedures for hundreds of his patients in Iran.In 2014 he started working on Lifting and Filling Threads and now Dr. Javili is one of the most experienced and best doctors in the world in the field and overly non-surgical methods of aesthetic medicine. He has already managed and held a dozen teaching courses and workshops as a teacher so he is one of the most experienced and well-known teachers in the field in the world as well. He speaks Persian, English, Russian, German, Ukrainian and Turkish. He is born in 1970 in Iran and recently moved to Turkey and works in Istanbul.
Background: Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia and urinary or fecal incontinence. Advanced disease has a considerable impact on the quality of life and it is associated with increased risk of vulvar squamous cell carcinoma (SCC) with 4%-5% risk. There is no definitive cure for LS nor is there a comprehensive treatment to cover all patients. The current "gold standard" treatment for lichen sclerosus is ultrapotent corticosteroid creams. The aim of this study is to evaluate the safety, symptom resolution and objective improvement in a patient diagnosed with VLS, after an innovative, regenerative treatment, which is based on injection of Heterologous Type I Collagen ( HT1C). Case Study: This case study is to evaluate the compliance, the efficacy and safety of HT1C intradermal injections to a female patient of 36 years of age, with diagnosis of biopsy proven active VLS, relatively unresponsive to topical steroid treatment. Results: The patient exhibited clinical improvement in the size of her lesions after the first treatment and after the third treatment the lesions disappeared completely. She had become free of symptoms and still is free of symptoms three months after the final treatment. After the first treatment she no longer needed to use steroids. She reported minimal to moderate pain and there were no side effects. Conclusion: Traditional medical management can require months of daily treatment and maybe relapse after discontinuation of treatment. Heterologous Type I Collagen offers a promising alternative to medical management. It gives excellent results with basically no side effects and no need of combined topical or systemic medication. However, further investigations and larger trials would be necessary to clarify the exact role of HT1C treatment, which looks promising.
Andrea Corbo Rome (Italy) is an Italian Dermatologist and a University lecturer. He teaches Dermatology and Aesthetic Medicine at the International University of Camerino at Level 2 Master in "Facial Aesthetic Medicine and Therapeutics". Private Practitioner in Dermatology and Aesthetic Medicine since 1992 and Speaker at National and International Dermatology and Aesthetic Medicine Congress. In 2007 he founded Medical Spa in Rome medical and training centre and since 2008, he's been leading the "Theoretical and Practical Anti- Aging course", an annual symposium for Aesthetic and Anti-Aging Medicine.
Toxic epidermal necrolysis (TEN) is a potentially life-threatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis and/or death (see the image below). Mucous membrane involvement can result in gastrointestinal hemorrhage, respiratory failure, ocular abnormalities, and genitourinary complications. We received in our clinic two cases of toxic necrolisis, unfortunately one of them died due to sepsis, the other we saw him in our clinic last month for a follow up consultation and he is very well. Toxic necrolisis is a severe dermatosis; the most common causes are antibiotics and antiepileptics. Here in South Africa because of the VIH/aids first cause is the anti-retroviral medication. 1st case: a 32 y/o male patient, vih + on alluvia for 2 years, came to hospital referred from the local clinic, complaining of a week history of blisters on the body and peeling of the skin, after he started with panado and tramadol prescribed at the clinic due to back pain. On examination a wild spread almost generalized blistery rash and denuded areas on back and trunk, also hyperpigmented patches can be seen on trunk and limbs, oral mucosa with secretion and exulcerations. Patient was admitted in our ward and started with steroids, fluids and antibiotics. Dressings daily with sterile water and we used paraffin gauze and bandage, was isolated for 4 days and same treatment no blisters, peeling areas healing, was seen by dietician and continue with fluids, mouth improved and he could eat, also started on prednisone 60mg daily oral and continue with antibiotics. On the 10th day with healing areas no new blisters, we decided to move him to high care room; Day 13th was very well, we discharged him on 50mg of prednisone. And should continue with the dressings at the clinic. When we saw him, on examination the denuded areas were healed. 2nd case: 43 yr. old male. RVD negative: Elisa. Type II DM: poorly controlled. On metformin and insulin.Followed up at the local clinic until September 2015.1st referral to casualty with uncontrolled HGT. Seen monthly at OPD south for uncontrolled HGT.No bloods ever done in OPD south. Pt seen by Dietician x1.Pt subsequently developed peripheral neuropathy due to uncontrolled DM. Started on amitriptyline and pyridoxine. In November 2015, Doctor in OPD south notes that Amitriptyline is not working and changes pt to tegretol.pt forgot tegretol at Pharmacy. Tegretol prescribed in December again and issued to pt. Last script on the 7th Jan 2016.Patient presented again in casualty on the 19th Jan 2016 referred by local clinic at 19hoo. Referral notes: oral sores, difficulty swallowing, itchy rash all over body, respiratory distress and swollen lips. Pt treated the previous week with same problem and no response. Assessed as an allergic reaction, treated with phernagan and referred.Pt triaged in casualty at 19h40. similar history noted by triage sister. Pt seen by doctor at 20h40.assessed as maculopapulo rash and fever of unknown cause. Vitals: T=37.7, P= 152, ICT= NegBloods: normal( U+E, CMP, FBC). HBA1C=6.9%, CRP=58, ESR=33 Seen at 12h00 by dermatology.Admitted to the ward.Pt only gets to the ward at 18h00 on 20/01/16Tegretol part of script. CWR: diagnosis reviewed again as TEN. Pt is moved to isolation and treatment remains unchanged. Surgery consult done for dressing of skin. On subsequent days it is noted bymultiple doctors that pt is not getting adequate hydration and skin is left uncovered and entire skin is peeling off. Formal complaint is laid with sister in charge. Still urine is noted to be coke coloured and pt is severely dehydrated.Early on 30th Jan 2016 doctor on call gets called to ward pt condition has worsened. Pt in septic shock with respiratory distress.Pt resuscitated and started on adrenalin infusion. Handed over to on call team in the morning. MO sees pt and plan is made. Pt re assessed at 13h3o in the afternoon and declared dead.Septicemia with septic shock (immediate).TEN due to tegretol The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulfonamide antibiotics, and nevirapine. Other causes can include infections such as Mycoplasma pneumoniae and cytomegalovirus or the cause may remain unknown. Risk factors include HIV/AIDS and systemic lupus erythematosus. Diagnosis is based on a skin biopsy and involvement of more than 30% of the skin. TEN is a type of severe cutaneous adverse reactions (SCARs), together with SJS, a SJS/TEN, and drug reaction with eosinophilia and systemic symptoms. It is called SJS when less than 10% of the skin is involved and an intermediate form with 10 to 30% involvement. Erythema multiforme (EM) is generally considered a separate condition. Treatment typically takes place in hospitalsuch as in a burn unit or intensive care unit. Efforts include stopping the cause, pain medication, and antihistamines. Antibiotics, intravenous immunoglobulins, and corticosteroids may also be used. Treatments do not typically change the course of the underlying disease. Together with SJS it affects 1 to 2 persons per million per year. It is more common in females than males.Typical onset is over the age of 40. Skin usually regrows over two to three weeks; however, recovery can take months and most are left with chronic problems. The diagnosis of TEN is based on both clinical and histologic findings. Early TEN can resemble non-specific drug reactions, so clinicians should maintain a high index of suspicion for TEN. The presence of oral, ocular, and/or genital mucositis is helpful diagnostically, as these findings are present in nearly all patients with TEN. The Nikolskysign (a separation of the papillary dermis from the basal layer upon gentle lateral pressure) and the Asboe-Hansen sign (a lateral extension of bullae with pressure) are also helpful diagnostic signs found in patients with TEN. Given the significant morbidity and mortality from TEN, as well as improvement in outcome from prompt treatment, there is significant interest in the discovery of serum biomarkers for early diagnosis of TEN. Serum granulysin and serum high-mobility group protein B1 (HMGB1) are among a few of the markers being investigated which have shown promise in early research.
Dr Leroy Olaechea Varona, Specialist in Family Medicine and Dermatology, born in Cuba. Had worked in countries like Venezuela, Aruba, and for 3 years he is been working in South Africa.
Genital ulcers are defined as breach in the continuity of genital mucosa and /or skin. Sexually transmitted infections (STIs) causing Genital ulcer disease (GUD) are syphilis, chancroid, donovanosis, lymphogranuloma venerum (LGV) and herpes genitalis. GUD can have varied modes of presentation with varying symtomatology. The documentation of an etiological agent of GUD remains difficult practically. Etiological diagnosis requires availability of laboratory facilities, absolutely inexistent in most health care centers and hospitals in developing countries. The etiological agent may not be demonstrated due to self medication by the patient or the ulcers may be contaminated. The clinical diagnosis may be misleading due to the increasing HIV co-infection and mixed infection often alters the morphology of ulcer. Because of the changing sexual behavioural pattern, the ulcers may not remain confined to the genitalia and may be seen in extragenital sites. It has been observed that the clinical diagnosis was incorrect in about 40% of GUD patients in comparison to laboratory tests. Atypical cases keep us in a diagnostic dilemma. It should never be presumed to be due to a single etiological agent. All available laboratory facilities within reach should be utilized as far as practicable.
Romita Bachaspatimayum has done her M.B.B.S and M.D (Dermatology, Venereology and Leprosy) under Manipur University and F.A.M under the University of Greifswald, Germany (ILAMED, Mumbai). She scored highest marks in Social and Preventive Medicine and Medicine. She is working as Assistant Professor at Regional Institute of Medical Sciences,Imphal,Manipur, India. She has published 21 papers and co-authored a chapter in Monograph on HIV ( Indian College of Physicians), has been a resource person in RDLS series (CoE,ART centre, RIMS) and attended various training programmes on STI (MACS,NACO). Her areas of interest are Cosmetic Dermatology, Genodermatosis and HIV. She likes writing and photography.
Introduction: Demodecidosis is the term applied to skin disease caused by mites of the genus Demodex. D. folliculorum and D. brevis. Objective: To describe the clinical features, the degree of infestation of patients with Demodecidosis and treatment received and the number of weeks to get cured. Methods: A descriptive, observational, retrospective study including records of patients diagnosed with Demodecidosis in the period of February 1 2017 to February 1 2018with a follow-up consultations recorded in the clinical record was made. Results: 31 records were obtained, 16 were excluded because of missing records in monitoring, confusion in the clinical variety and / or lack of skin surface biopsy. There were 2 men and 16 female patients. The most common clinical variety was Pityriasis folliculorum with 50%, followed by acne rosacea-like 27.8% and erythematous isolated papules 22.2%. The 42.9% of patients with Pityriasis folliculorum had more than 5 demodex per follicle. There maining varieties hadlessthan 5 demodex per follicle. The treatment received based in shampoo selenium disulfide as monotherapy in patients with<5 demodex by follicle, and the use of selenium disulphide in combination with ivermectin at above 5 Demodex by follicle reported good results after two weeks of treatment. Conclusion: Demodecidosisis a common condition in our practice that requires more descriptive studies and controlled clinical trials for better approach.
Dante Villamil Cerda has completed his Ph.D at the age of 28 years old at the National University of Mexico in Mexico City. He is the director of Krankenhause Dermatopath Lab. He has published in the American Journal of dermatopathology with special interest of collagen anomalies.
The incidence of basal cell carcinoma is increasing over the world and is one of the most costly tumors, however has lower rate of mortality; these tumors promote high rates of morbidity in face cosmetic locations. To show the aesthetic effect throughantitumor effect and avoiding mutilations.The formulation of HeberFERON containing co-lyophilized recombinant IFNs alpha2b and gamma has been employed in several clinical trials in patients with non-melanoma skin cancer (BCC, SCC), administered peritumoralin doses from 3.5 -10.5 MIU, 2-3 times per week.Patients (N=215) with BCCwere treated with HeberFERON(3.5 or 10.5 MUI). Histologic characteristic of tumors were as followed: Nodular (59.1%), superficial (10.2%), basosquamous (5.6%), nodular pigmented and cystic adenoid (1.9%), sclerodermiform and queratotic (1.4%). Other subtypes (<1.0%) were solid ulcerate, infiltrative and pleomorphic. The correlation between tumor localization and response indicate that the 100% of tumors located in the neck (n=6) had a CR, followed by those of eyelids (83.3%), trunk (76%), arms (66.5%), and nose (65%).The diseasecontrol rate (DCR) of 98.6%, with 61.9% CR and 88.4% OR were detected. No recurrences were observed after 5 year in followed patients. Patients with SCC of the skin presented a DCR of 95% with prolongation of the responses for at least 5 years. Observed adverse events were mainly flulike symptoms of mild to moderate intensity, all controlled with antipyretics. Cosmetic effect is highly favorable in patients treated with HeberFERON. Post-marketing evaluation of 590 patients showed that in patients with therapeutic indication of partial mutilation (17% of patients) of nose o ears this procedure was avoided using perilesional HeberFERON. HeberFERON showed a good control of lesion burdens in patients with Gorlin Syndrome. HeberFERON is a new curative, safe and easy to use, non-surgical treatment for non-melanoma skin cancer with excellent aesthetic effect.
Professor Iraldo Bello-Rivero graduated as a Master of Science in Chemistry in Mechnikov National University in Odessa, Ukraine in 1983 and carried out fellowships with Dr Michel Aguet (1988) at the Institute of Immunology and Virology, Zurich, Switzerland, with Dr Erik Lundgren (1994) at the Department of Molecular Biology, Umea University, Sweden and with Dr Marco Soria (1995) at Department of Biological and Technological Research, San-Raffaele Scientific Institute, Italy. He was the head of the Clinical Trial Laboratory at the Center for Genetic Engineering and Biotechnology (CIGB), Havana, between 1994 and 2005. Currently, he is the Project Manager for HeberFERON at CIGB. He earned his PhD in Biological Sciences in 2005 at the University of Havana. Cuba.His scientific work concerns clinical trials on interferon in skin cancer. He has published more than 30 papers in reputed journals and received Cuban Academy of Sciences Awards in both 1990 and 2006 and a Public Health National Award (Cuba) in 2010 and 2016. He is author of three patents
Background: Injecting cosmetic fillers is increasing worldwide and desiring a 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 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 and Methods: We enrolled patients who were unsatisfied 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 Barikbins tumescent solution to facilitate the evacuation of concentrated gel and reduce the risk of injury to vital tissues. We inserted a 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 unsatisfied with the results. Patients reported no complication of therapy. Conclusions: Our method provided good results and performing evacuation under the guide of bedside ultrasonography is recommended.
Shun Io President, Plastic & Cosmetic Surgical Society of Macau Surgical Association Associate Doctor, Specialist in Plastic Cosmetic Surgery, Yi Kui Hospital (Macau) Medical Consultant, Paul Niehans Anti-Aging Center (Asia) Specialist in Cosmetic Surgery, Taiwan Specialist in Aesthetic Medicine, Taiwan Specialist in Anti-Aging Medicine, Taiwan Official Trainer of Derma Veil Aesthetics Training Official Trainer of Stylage Aesthetics Training Certification of Completed BOTOX Aesthetics Training Certification of Completed Juvederm Aesthetics Training Certification of Completed Restylane Aesthetics Training Certification of Completed Sanofi Sculptra Aesthetics Training.
Introduction Regional nodal metastases from high risk cutaneous squamous cell carcinoma (cSCC) are strongly associated with poor prognosis but difficult to predict clinically. Materials and methods Patients presenting with high risk cSCC of the head and neck with clinically N0 necks were offered sentinel node biopsy (SNB) at the time of primary cSCC excision or at time of secondary wide local excision. Results 105 patients underwent SNB with a total subclinical nodal metastasis rate of 14.3%. Significant predictors of metastasis were 4 or more inclusion criteria, depth of invasion greater than 5mm and PNI. Conclusions Recent work in molecular analysis of cutaneous SCC’s hopes to identified mutations that may predict tumour behaviour better than currently used clinicopathological features. Targeted DNA methylation analysis, gene and protein expressionin the primary are showing promise along with other genetic mutations. If specific tumour genotypes capable of regional metastasis can be identified, then SNB could be targeted to patients at high risk of nodal metastasis.
Richard Martin is a New Zealand trained general surgeon who spent two and a half years at the Sydney Cancer Center specialising in melanoma and head and neck surgery. Most of his time was spent at the Sydney Melanoma Unit, the largest treatment and research facility for melanoma in the world. During his time in Sydney he completed a Master of Surgery in Surgical Oncology at the University of Sydney. As a Surgical Oncologist Richard assesses and treats all forms of melanoma, skin and head/neck cancer. Richard works in the multidisciplinary Melanoma Unit team, and for Waitemata District Health Board (North Shore and Waitakere). Private patients are seen at the Waitemata Specialist Centre, Takapuna and the new Rodney Surgical Centre at Warkworth.
The authors hereby present their five-year experience since 2014 with suture suspension threads with absorbable cones, boasting over 600 implant procedures of various types and in different areas of the body.The bi-directional threads with Silhouette Soft cones are made of absorbable polylactic acid materials with a 3/0 diameter and are mounted on two 23G-12CM straight needles. A series of counterposedcones (made of Glycolic Acid), separated by a 2-CM gap, are found along the thread and are fastened by the same threads knot.The 8-cone version (30 CM in length) and the 12-cone version (27.5 CM in length) are specific for facial tissue repositioning, while the 16-cone version (26.8 CM in length) is better indicated for the body (arms, abdomen, inner thigh and gluteus). Threads must be implanted in the subdermalplane and the treatment area must be prepared with minimal local anesthesia in both the entry and exit points with a vector needle.The most commonly used techniques are the "linear" ,"V" and "U" shaped. The aesthetic effects are mainly attributed to the counterposed cones which, by anchoringthemselves to the subdermal tissue, determine a lifting effect of the tissue, but also to the polylactic acid which in the months following the procedure creates volume and stimulates collagen fiber production by recalling water.The Silhouette Soft sutures implant is considered an excellent combination with Hyaluronic Acid procedure and BotulinumToxin treatment in order to achieve more harmonious and long-lasting aesthetic results.The aesthetic results with cone sutures are already visible after a week and can be considered stable for 12 months.
de Benito J, Pizzamiglio R, Theodorou D, Arvas L. Facial rejuvenation and improvement of malar projection using sutures with absorbable cones: surgical technique and case series. Aesthetic Rust Surg. 2011;35(2):248-253 Lycka B, Bazan C, Poletti E, Treen B. The emerging technique of the antiptosis subdermal suspension thread. Dermatol Surg. 2004; 30(1):41-44; discussion 44. Rejuvenating the Face: An Analysis of 100 Absorbable Suture Suspension Patients Michael Patrick Ogilvie, MD, MBA; Julius Warren Few, Jr, MD, FACS; Shikhar Singh Tomur, BA; Chad Michael Teven, MD; Alec James Semersky, BA; Caroline Regan Bruno, MSN, NP-C; and Natasha TamagniKulick, BA Aesthetic Surgery Journal 2018, Vol 38(6) 654-663 c.-() 2017
In aesthetic assessment of the face, relationship between cheekbones, nose and chin is often not correctly analyzed because of profile is not a constant entity, but is influenced by age, culture and historical moment. Several authors have tried to define parameters or canons to determine a perfect face, but often the results obtained have been far from reality. An accurate facial analysis therefore becomes indispensable for those patients who require an improvement in their profile that have defects in the middle-lower third. In recent years, minimally invasive medical procedures appear thatare able to offer low downtime with improved skin and tissue quality, low risk, good cost-effectiveness, and rapid recovery to social life for patients. MATERIALS AND METHODS From December 2017 until June 2018, 200 patients who needed non-surgical facial profiloplasty were treated with hyaluronic acid with Vycross Technology. They have received a correction of hyaluronic acid into the zygomatic region, the chin, the lips, the mandibular region and possibly into the nose. Patients were evaluated clinically, using pre-post-treatment photographic images and a three-month follow-up. RESULTS The non-surgical profiloplasty is an essential aesthetic canon in the harmony of the face. The proportions of the face in fact contribute to define a beautiful and attractive face. Less and less invasive methods and with an increasingly reduced downtime allow us to restore the aesthetic defects of our patients' faces. KEYWORDS Profiloplasty, filler, hyaluronic acid, facial analysis, mentoplasty, rhinoplasty, Vycross technology.
Dr. Lucia Calvisi has been graduated at the age of 24 at the University of Cagliari with 110/110, Summa cum laude, honourable mention(full marks), and postdoctoral studies (residency in Dermatology) in the same University at the age of 28 with the score of 50/50 Summa cum laude (full marks). Actually, she is the Director of Centro Dermatologico Dott. Lucia Calvisi, located in Cagliari. She has published more than 10 papers in reputed journals and has been serving as an editorial board member of repute. She also is a teacher of several School of Aesthetic Medicine and works also a Consultant for pharmaceutical company in the field of aesthetic.
The rebalancing of convexity and concavity of the face as well as the restoration of facial volumes are an integral part of the facial rejuvenation project through hydrogel injection techniques. Lights and shadows created by the corrections of some particular anatomical areas promote to improve the patient's aesthetic appearance sometimes even with small quantities of product. The malar area and the nose are two anatomical areas involved in this volumetric correction technique. The reduction of the fat pad in malar area can induce some disarmonic profile with pseudoptosis of the the dermis compartment. The correct anatomic layer injection and the right products selection offer us the possibility of safe and efficient corretion with minimal down time for the patients. Unfortunately, an univoque technique and methodolgy do not exist but each implants is influenced by the clinical and anatomical conditions of the patient. Regarding nose correction the use of filler has completely modified the approch of the small aesthetical corrections . The so-called nonsurgical rhinoplasty with fillers in last few years has shown to be an effective alternative for patients seeking only an aesthetic improvement of the nose. Differences between Western and Asian noses usually are represented by a more projected anterior nasal spine (ANS) and a more or less pronounced hump, in the first group; however, some other anesthetic features, such as drooping of the tip, lateral displacement of the nasal tip crura, and deficiency of the upper lateral cartilages (ULC) can be observed.
Nicola Zerbinati is a Assistant Professor of Dermatology University of Insubria Varese Italy, Scientific Coordinator at ICAM, USA International Consultant in Aesthetic Medicine, Scientific Coordinator and Professor at the International Union of Lipoplasty IUL, Scientific Coordinator of the International Academy of Cosmetic Gynaecology IACG, Coordinator of the Laser Group Italian Society of Dermatology, Member of the Italian Society of Dermatology, Member of the Scientific Committee of the "International Congress of Aesthetic Medicine", Scientific Coordinator in Master in Ahestetic Dermatology University of Florence (2010-2011) and Scientific Coordinator "Master in Laser Dermatology" University of Tor Vergata Roma (2015-2016)
Aging is inevitable and a progressive process and face is the mirror of total body aging. Aging in face affects all facial layers, skin, subcutaneous fat, superficial muscular aponeurotic system (SMAS), deep facia, the retaining ligaments, neurofacial muscles activity, and even the facial bony skeleton. Rejuvenate procedures of the face are increasing in numbers, and a plethora of different therapeutic options are available today. Every procedure should aim for the patient’s safety first and then for natural and long-lasting results. Variable procedures for facial rejuvenation have been innovated through surgical and nonsurgical techniques, according to degree of tissue laxity, surgeon assessment, and patient preference. The most common nonsurgical tools for face rejuvenation are the dermal fillers, Botox, peeling, laser resurfacing, platelets rich plasm (PRP), and lifting using threads. Thread lifting is neither alternative to surgery nor magic per se, but it havegood results for rejuvenation and skin lifting, especially when combined with another methods of facial rejuvenation. Thread lifting gained popularity among patients as well as physicians, as it is minimally invasive, quick procedure, and can be undertaken at an outpatient clinic. In this job we propose the HEBE SOFT FACELIFT PROCEDURES, a personal technique, with a combined and standardized use of different no invasive procedure for the treatment of the different portions of the face with the aim of a natural result with reshaping of the face and without a doll effect. For a good and natural result, we program, for our typical patient, the treatment in two different steps. In the first session we use the botulinum toxin for the treatment of the upper third of the face, the gold standard procedure for this area.After fifteen days, when the toxin has given its effectiveness, we pass to the treatment of the middle and lower third of the face. Forthe medial third of the face, we combine filling of the deep fat bags with a gentle lifting of the sagging skin. For get skin lifting, we use polydioxanone threads. This resorbable device has small arrows that hook and lift the skin. To obtain satisfactory results we follow the tension lines of the skin of Langer. With the use of this sutures, positioned in blunt cannula we obtain lifting of zygomatic area, reduction of nasolabial folds and the reduction of the more heavy part of the jawline. Thanks to the sutures we use a very small quantity of Hyaluronic acid to filling of the malar, zygomatic and medial deep cheek bags fat, that we filling with retrograde vertical injections. and we have necessity to very small quantity of Hyaluronic acid to filling of the malar bag, zygomatic bag and medial deep cheek bag fat, that we filling with vertical injection. In the lower third of the face our goal is create a redistribution of the skin with a reduction the jawlineand depth of marionette fold. For this area we use two bidirectional barbed thread inserted in a sharp needle for each side, one for the marionette line and one for the jawline.The needle are injected in subdermal area posteriorly and exit anteriorly before the marionette fold, then, with a massage up the skin, we open the barbs and we obtain a distribution of the skin. The last procedure provides the injection of smooth threads with an hashtag technique in the chin area for create a new texture in the marionette fold area. The results of lifting and redistribution starting immediately but for the really effect that the new collagen fibers producing it's necessary wait minimum one month.
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The fear of leprosy leads to stigma and is due to lack of knowledge about leprosy. 4 The main purpose of this study is to assess knowledge and attitude of a tertiary Hospital staff in Caloocan City, Philippines about leprosy. A cross-sectional survey was conducted among the staff of a tertiary Hospital in Caloocan City, Philippines. Reason for choosing the staff was to assess their knowledge and attitude about leprosy since this tertiary hospital is formerly known as Central Luzon Sanitarium or Tala Leprosarium which accommodate patients suffering from Hansen’s Disease before the Hospital becomes a Tertiary Hospital treating Medical and Surgical cases.Two hundred and sixty eight individuals completed the questionnaire. More than half 51% of the participants were male (n-137). About 39% (n-104) were from the age group of 31-40 years old. More than half 63% of the participants were college graduates (n-169). About 51% (n-141) were from the medical group. The p-value for the test on difference in attitude between medical and non-medical staff is .654, which is greater than .05 level of significance. The p-value for the test on difference in knowledge between medical and non-medical staff is .000. The knowledge and attitude of a tertiary Hospital staff in Caloocan City, Philippines about leprosy is good. There is a significant difference between medical and non medical staff when it comes to their knowledge towards leprosy.Meanwhile, there is no significant difference between medical and non-medical staff when it comes to attitude towards leprosy
Geramie M. Acebuque has completed her Medical Education at the age of 28 years from Manila Central University– Filemon D. Tanchoco Medical Foundation. She is the Chief Resident of Dr. Jose N. Rodriguez Memorial Hospital Department of Internal Medicine.
Background:Two specialists triageskin lesions at WDHB for management of suspected malignancy using an innovative e-referral system. E-referrals include demographics, description of lesion(s), biopsy results and/or attached photograph of suspected skin cancer(s). Specialists prioritise e-referrals and decide management. Method: 929 lesions triaged with category "melanoma" were selected (2016). 'Triage category' selected was compared with 'definitive diagnosis'. Each management plan was recorded as ‘correct’ or ‘incorrect’. We determined PPV and NNE. Of lesions referred to teledermoscopy, we recorded dermatologist’s opinion, correlating this with biopsy. Results:315 lesions were graded based on photographs/descriptions, diagnosing 120 melanomas with PPV of 38.1% and NNE of 2.6. 241 melanomas were biopsy proven prior to referral. Lesions not graded for excision were evaluated with teledermoscopy (373) of which 9.2% were found to be melanoma on diagnostic excision. Conclusion: The e-referral system at WDHB has markedly improved successful predictive ability for picking up melanoma from previous benchmarks.
Richard Martin is a New Zealand trained general surgeon who spent two and a half years at the Sydney Cancer Center specialising in melanoma and head and neck surgery. Most of his time was spent at the Sydney Melanoma Unit, the largest treatment and research facility for melanoma in the world. During his time in Sydney he completed a Master of Surgery in Surgical Oncology at the University of Sydney. As a Surgical Oncologist Richard assesses and treats all forms of melanoma, skin and head/neck cancer. Richard works in the multidisciplinary Melanoma Unit team, and for Waitemata District Health Board (North Shore and Waitakere). Private patients are seen at the Waitemata Specialist Centre, Takapuna and the new Rodney Surgical Centre at Warkworth.
Fibromyalgia have one of the leading causes of neurological disorders and stroke in pharmaceutical Instituions. Health has the ability of a biological system convert into personal satisfaction. The world health organization (WHO) literature for human health in a broader sense in its 1948 constitution as "a state of complete physical and well-being and not merely the absence of disease or infirmity. It has been subject to controversy, in particular as poor transportation facility in pharmacy institution lacking operational value, the ambiguity in developing low health strategies and because of the problem created by use of the word " social determinants of health", which makes it practically impossible to achieve healthy environments. Understanding student health and disease with private based co-educational pharmaceutical institution has not transportation facility and low quality food in suburban areas of developing cities in India cannot ignore. Early decompressive adrenal insufficiency has accepted in medical science due to health imbalance. Fibromyalgia especially from junior students to senior students living with private institution with poor quality of life and facility can translate into permanent disability in the world. We cannot compare Fibromyalgia with joint pain. Fibromyalgia cannot ignore because it has weaken immunity has unfortunately not measured in the above series.
Dr. Rahul Hajare is bright student of Renowned Immunologist Honorable Respected Dr. Ramesh S Paranjape Retired Director and Apex body member of Indian Council of Medical Research New Delhi. He is Fellow Indian Council of Medical Research. He is PhD student of reputed University Vinayaka Mission Research Foundation Salem TamilNadu. He is winner of world academic championship-2017 in pharmacy (antiretroviral therapy). He is among world's 500 most influential experts in pharmacy for the year 2017 on earth. He is alumni of The Yoga Institute Centenary Celebration Mumbai.
Introduction Periocular hyperpigmentation (POI) is a common condition in the daily practice of the aesthetic doctor. It has a complex pathogenesis, it is difficult to treat, and the need for treatments that need to be repeated over time. It aggravates with the process of cutaneous relaxation and / or alteration of subcutaneous fat. It is an important aesthetic problem because it gives a tired and aged look. The POI can be considered by etiological factors concerning genetic / constitutional deposition, deposition of dermal melanin, post-inflammatory hyperpigmentation, secondary to dilatation from atopic or allergic contact and the superficial localization of the vascular system; other causes are due to anemia, hormonal disorders, nutritional deficiencies and skin laxity; even bad habits come, smoking and irregular sleep patterns are considered high risk factors of IPO. The therapeutic approach of the POI must be linked to the cause; in case of excessive pigmentation, topical whitening agents and peeling are considered classic therapies. The use of Laser, filler and autologous fat transplant is based on very variable success rates, often unsatisfactory for problems and for the doctor. In this work we have considered the combined use of carboxytherapy (CDT) and peel based on mandelic acid, pyruvic acid and lactoferrin. Materials and Methods All patients underwent a careful collection of the anamnesis with evaluation of age, sex, profession, familiarity with IPO, sleep rhythm, diet, lifestyle, smoking habits, time spent using cell phones and computers. In all cases an assessment and classification of the severity of the IPO was carried out using a visualanalog scale (VAS) with a score from 0 (negative) to 10 (severe); they were then divided into mild if VSA 1-4, moderate with VSA 5-7, Grave with VAS 8-10. In all cases he was also required blood count and coagulation to rule out anemia and / or coagulation disorders Patients with periocular hyperchromia and peri-orbital wrinkles who had not undergone any previous treatment were included in the protocol, except for any botulinum toxin treatment. At the time of inclusion in the protocol, the treatment protocol was accurately informed, and informed consent was given to them. The intended protocol was represented by: A. CDT two weekly sessions with flow 110 cc / min. with 5cc administration for eyelid for 4 weeks; B. After the first week we proceeded to Peeling with Mandelic acid, pyruvic acid and lactoferrin weekly for three sessions in the eyelid area; C. Home treatment with cream based on hyaluronic acid, mandelic acid and lactoferrin to be applied twice a day. All patients were given a photographic study with a basic evaluation at the end of the treatment cycle and every month up to six months later. Results From January 2017 to January 2018 we treated 20 patients (15 women 5 men) with an average age of 40 (range 22-60 aa). 6 cases belonged to a mild IPO framework, 10 to a moderate framework and 4 to a severe framework. All patients completed the protocol; in no case do they observe complications or side effects, except for 5% of cases of persistent palpebral edema after CDT with spontaneous reabsorption within a few hours. All patients were satisfied with the results obtained with a higher satisfaction rate in mild and moderate cases. In all cases the patients reported, in addition to the reduction of the POI, a marked improvement in the texture and elasticity of the skin with marked attenuation of the micro roughness, if present. Conclusions We consider this our method, not invasive, not excessively expensive and repeatable over time, a valid aid in the treatment of POI.
Will be updated soon
Cellulite? Curri, Bartoletti C.A and many others consider it to be a highly prevalent pathology in female subjects, in which it has a significant negative impact in terms mainly aesthetic, then there are the Anglo-Saxon scholars that cellulite consider it a simple skin imperfection. The etiopathogenetic controversies on cellulite are usual, but little has been produced from a scientific point of view, except for the work that demonstrates a genetic component in the pathogenesis of cellulite, linked to the presence of the "D" allele (deletion) in the gene coding for the angiotensin converting enzyme (ACEtaneo, published by an Italian. Recently, a hypothesis of cellulite origin has been published that does not contemplate for the first time the adipose tissue, but the presence and action of some cells present in the dermis between the sweat and the sebaceous gland. These studies seem to be confirmed in another study not yet published which highlights the presence in the dermis of the Muse cells and the deposit in the dermis of more than 700 proteins with an interest in worsening oxidative stress. Important scientific controversies when these stimulate the deepening of studies and knowledge and not the pirate marketing proclamations of an Anglo-Saxon nature, able to solve the cellulite that in fact without unequivocal thoughts is a disease.
With an eternal passion for medicine, Ines Mordente has studied the diagnosis and prevention of melanoma, living for a period in New York, where he won a Fellowship in Oncological Dermatology at the prestigious "Sloan Kettering" Hospital Cancer Center ".In his training, Ines Mordente received the Diploma of Aesthetic Doctor of the Postgraduate Course at the Federico II University of Naples, as well as numerous other university training courses, in aesthetic dermatology. She is the author of numerous scientific publications in national and international journals, as well as a speaker at many international conferences. Today Ines Mordente is a Professor at the Master of Aesthetic Medicine at the University of Palermo and works as a Dermatologist in private practice and in consultancy at other centers, where she practices specialist visits in Clinical and Allergological Dermatology, Venereology, Pediatric Dermatology, Aesthetic Medicine and Regenerative.
Bioquantine a mRNA extract from Xenopus laevis frog oocytes (purified from intra- and extra-oocyte liquid phases of electroporated oocytes), showed potential as a treatment for a wide range of conditions in animal models, including Spinal Cord Injury (SCI) and Traumatic Brain Injuries (TBI) among others. The current study observed beneficial changes with Bioquantine administration in a patient with a severe SCI. Pluripotent stem cells have therapeutic and regenerative potential in clinical situations CNS disorders. One method of reprogramming somatic cells into pluripotent stem cells is to expose them to extracts prepared from Xenopus laevis oocytes. Due to ethical reasons and legal restrictions we selected a No Option patient, deciding to include in our protocol the RestoreSensor SureScan to complete it. Based on the electrical stimulation for rehabilitation and regeneration after spinal cord injury published by Hamid and MacEwan, we designed an improved delivery method for the in-situ application of MSCs and Bioquantine in combination with the RestoreSensor SureScan. To the present day the patient who suffered a complete section of spinal cord at T12-L1 shows an improvement in sensitivity, strength in striated muscle and smooth muscle connection, 14 months after the first Bioquantine and MSCs treatment and 9 months after the placement of RestoreSensor at the level of the lesion, showing an evident improvement on his therapy of physical rehabilitation (legs movement) on crawling forward and backwards and standing on his feet for the first time and showing a progressively important functionality on both limbs.
Dr. Osorio is an innovative businessman with a distinct entrepreneurial mindset concentrated adding value on areas of Biotechnology (mRNA), Reprogramming & Regenerative Medicine for translational use in humans and a variety of clinical applications aimed for both the private and the public health sectors. Dr. Osorio is the Founder, President, and CEO of RegenerAge Clinic and RegenerAge Beauty initiatives for transnational implementations. Vice President and International Clinical Developer for Bioquark, Inc. Executive Vice President: Chairman of the WAMS Americas Division, member of the WAMS Executive Council (WAMS Executive Board), a member of the WAMS Education & Training Board (ETB), a member of the WAMS Editorial Board, an Honorary Member of the Academy Faculty FWAMS, an Honorary Fellow of the Academy & is also a Senior Partner at WAMS, The World Academy of Medical Sciences.
Since my Ob/Gyn residency years 1981-1986 I have had to face patients treated with radical vulvectomy among those other oncologic patients treated for ovarian cancer or cervical or endometrial cancer. Only referring to external genitalia, radical vulvectomy, or now a days partial vulvectomy, are usually treated with reconstructive surgery but no interest or importance were driven to functional aspects of the results of surgery until recent years. Moreover, at that time, cosmetic surgery of female genitalia was very far to be talked about in usual discussion in briefing e debriefing meetings. That time, little words were spent to dispareunia for dry vagina or to the falling of sexual pleasure for a large vaginal introitus (vaginal rim) or to residual pain in pelvic area, and definitely no words to the problem of a woman with large labia minora wishing to ride a bicycle or to attend a gym or to wear a tight and sexy bath robe. Today things has changed to the point that the American College of Ob Gyn (ACOG) has set a list of recommendations for women (often young women) who wish to have this kind of cosmetic treatment, and also to the point that unfortunately even dentists are going nowadays to treat vaginal misfeelings with a vaginal laser device or a radiofrequency vaginal probe. In my experience after the two residency periods (Ob-Gyn and Plastic Surgery) I have had many times to face quite different situations of womanhood ranging from an excited woman wishing to have a more beautiful external genitalia to the weeping lady who asks for revirgination after a divorce from a very rude husband (and I will show the effect of a rude intercourse in a picture taken at consultation in my office). For all these issues, and many more, I think we have to respect the desire of women wishing to have cosmetic surgery of their genitalia , to forget “tailored vagina” or “vagina a’ la carte” which are similar fool words as “faceboost” used for facial antiaging revitalization, and offer a well thought and good resulting cosmetic procedure for female external genitalia. I will present both surgical procedures dealing with hymenoplasty to labia minora and majora surgery (with some suggestions not to be involved in danger situations) and medical outpatient procedures, the last ones ranging from the use of hjaluronic acid and PRP to fat transfer.
Prof Erri Cippini got the Degree in Medicine and Surgery at Milan University (Italy) on 18.12.1981 with full marks and honour (110 cum Laude) and he won also the award for the best student with the highest marks during his fifth year of the sixth year academic duration Degree. Prof Cippini completed a full Residency program in Ob/Gyn at Milan University (Italy) and ten years experience in Oncology Gynecology at the University Hospital of Brescia (Italy) that progressively evolved towards Reconstructive Plastic Surgery after cancer and malformations, with special interest in Face Breast Abdomen (also Bariatric Surgery) and Female Genitalia that addressed him to a second full certified Residency in Plastic Reconstructive and Cosmetic Surgery at the same Milan University. In July 1990 he got the ECFMG certification (USA), then GMC (UK) certification also in the Specialist Register as Plastic Surgeon since February 2009, moreover FMH certification (Switzerland) both for Medical Degree and Plastic Surgery with licence to practice since 13 August 2009. Enrolled (one of fifteen Italian doctors) on 30 October 2012 in an international (European) study protocol on Azzalure (botulinum toxin A) from Galderma. Former Scientific director of a swiss settled Foundation on evolutive procedures for treatment of human ailments, with the first observational case of bedsore (pressure ulcer) resolved (under personal suggestion) with exosomes of mesenchimal stem cells from homologous-allogenic adipose tissue. Professor chief of Plastic Surgery Teaching Program (from yr 2006/2007 to yr 2010/2011 which is the complete duration of the program) at the University of Brescia, Faculty of Medicine and Surgery, for the Course Degree in Medical Biotechnology and former instructor of Anatomy at the Medicine Faculty of the same University.
For more than thirty years the regenerative ability of Heterologous Collagen Type I has been known and used in medicine. Quite recently the same molecule is available for intradermal injection procedures. The Heterologous Collagen Type I is able not only to act as a growth factor on fibroblasts but also provides a potent stimulus for biosynthetic activities, in particular for neocollagenenis. The substantial novelty of this approach lies therefore in the induction of fibroblasts replication, with the increase in the number of such cells in the dermis. Consequently, we are talking about bio-regeneration (which is based on mitosis) instead of bio-stimulation (which is based only on induction of cell anabolism). Authors present new uses of the injectable product that exceeds the classical role in dermal biostimulation and discovers new indications and new application areas. Heterologous Collagen Type I has the ability to treat several problems, such as non-pathological gingival retraction, skin laxity, stretch marks, aging of the external genitals, acne scars. This approach shows great efficacy alone but also in combination with other treatment methods, with which Heterologous Collagen Type I is perfectly compatible.
Andrea Corbo Rome (Italy) is an Italian Dermatologist and a University lecturer. He teaches Dermatology and Aesthetic Medicine at the International University of Camerino at Level 2 Master in "Facial Aesthetic Medicine and Therapeutics". Private Practitioner in Dermatology and Aesthetic Medicine since 1992 and Speaker at National and International Dermatology and Aesthetic Medicine Congress. In 2007 he founded Medical Spa in Rome medical and training centre - and since 2008, he’s been leading the "Theoretical and Practical Anti-Aging course", an annual symposium for Aesthetic and Anti-Aging Medicine.
The lips are a focal point of the face and their aesthetic proportion has an effect on facial attractiveness. Perioral aging is highly individual with several distinct processes taking part simultaneously and theycan act on lip volume and length, lip shape and degree of vermilion inversion. In literature there are numerous measurement scales and algorithms based on a separate analysis of the lips for the rejuvenation of the peri-labial area.6-11 However objective measurements, that remain the foundation for aesthetic evaluations, are still poorly definedand they could help to indicate the right rejuvenation approach among the multitude of treatments. This study analyzes the parameters that make lips attractive, developing specific guidelines for achieving a natural look. The author,through the evaluation of four specific parameters(philtrum height, upper vermillion height, ratio between philtrum and upper vermillion height, golden ratio between upper and lower vermillion height),has allowed to a numeric definition of the lips. This new classification, with its associated analytical guidelines, can help practitioners in customizing the proper lip treatment for each patient to achieve the "ideal lips" based on specific and measurable characteristic of the labial area.
Prof. Sito received his medical degree from University of Naples in 1978. He completed his training through Specializations in: Emergency Surgery (Naples), Urology (Rome) and Endocrine Surgery (Naples). He is a full professor in Anatomy at Luigi Vanvitelli University of Naples and Scientific Director at Pegaso University in Aesthetic Medicine Masters. He is also a member of the Italian Society of Plastic and Aesthetic Surgery and he is author of many books concerning Plastic Surgery and Aesthetic Medicine and has published more than 100 scientific papers in Italian and foreign journals.
Suppurative Hydranetisis (HS) is an inflammatory cutaneous disease reguarding young age, that has beeen in shadow for a long time, until now. It has been said that we have few informations about it, that we have a few strategies of treatment, som there ‘s a lot of road to straight on. It reguards 1 % of people and 4% of these are teen agers or over there. Too often misdiagnosed, it need of most attention from scientic world. Environmental factors are responsable in pathogenesi of this skin disease, like obesity and smoke, but hormonal and genetics factors are responsable too. Few notice give us as possible treatments from simple antibiotics to surgical intervention, but this one often is not accepted for its importance and gravity. Other medical deviceses colud be used with the limit of young age of these patients. So the acknowledgement tha inflammatory citokines are present in pathogenesis of HS open a new profile of possibles medical interventions.
Valentina Dente was born in 18 th Jan 1977 in Naples, Italy. She has completed her degree in Medicine and Surgery at the age of 24 years old from University Federico II of Naples, where, she then became Specialist in Skin And Sexual Diseaease at the age of 28 years old. She attended as volunteers, Dermatological and Surgery Department of Loreto Crispi Presidio Intermedio of Naples in 2009, 2014 and 2015 years, and San Gennaro Hospital of Naples in 2015. There she winned a Campanian Region scholarship titled “HPV related disease and others sexual diseases: projects for primary and secondary prevention and for diagnosi of HPV diseaese” from october 2015 to december 2016. Winner as tutor of the “RETHINK” post- spescialist projact to monitor psoriasic disease patients quality management, in Del Mare Hospital of Naples from october 2017 to october 2018. She practices Clinical Dermtology in most of Public Structures of Centre- South of Italy as Specialistic Acting from novembre 2005 for around 6.000 hours of job. Author of around thirty from scientific Poster, Articles, Congress, Comunications, TV Format end e-articles. Winner and selected for National and International Panels, Member of ADOI and of American Chemical Society from 2015.
Studies have shown that dermatological conditions are common among HIV infected patients, with a prevalence of up to 90%, and constitute a substantial part of medical problems encountered at healthcare facilities. Ongoing healthcare and treatment for patients with skin diseases can be optimised by understanding the incidence and population prevalence of various skin diseases and the patient- related factors which determine the use of healthcare facilities. Recognition of HIV-related skin conditions may lead to early diagnosis and appropriate treatment. With the advent of ART, there has been a significant decline in skin conditions. The aim of this study is to describe prevalence, types and severity of dermatological conditions and to explore treatment outcomes and effects of ART among HIV-infected patients, and to give recommendations. A retrospective cohort analysis was performed of all patients attending the dermatology clinic. A total of 361 patient files seen from January 2015 to February 2016 were reviewed. There were 146 males and 215 females, with ages ranging from 1 month to 89 years. 262 patients knew their HIV status; 117 (45 %) patients were HIV positive and 145 (55 %) patients were HIV negative. HIV status was unknown in 99 patients and were excluded from the study. The most frequent dermatological diagnoses included eczema/ seborrhoeic dermatitis (n=95) molluscum contagiosum (n=29), Kaposi’s sarcoma and other skin tumours (n=24), acne/rosacea (n=13), superficial and deep fungal infections (n=12), PPE/folliculitis (n=15), drug eruptions (n=11), lichen planus/nitidus (n=6), impetigo/ecthyma (n=5), lupus erythematosus (n=4), Herpes zoster virus(n= 3), and scabies (n=3). Of the 117 HIV-positive patients, 85 patients had HIV-related skin conditions. Dermatological conditions are common in this cohort, with more females than males. Commonest conditions among children were molluscum contagiosum, eczema and seborrheic dermatitis.
Beauty is a General and Aesthetic Medical Practitioner with over 20 years working experience in diverse clinical fields. She has clinical skills in the treatment of HIV/TB, Clinical and Aesthetic Dermatological disorders at General Practioner level(GP-IS Dermatology). Beauty holds an MD(Minsk, Belarus), an MSc in Global Health and Infectious Diseases(University of Edinburgh), Derrmatology Diploma(Australian Institute of Dermatology), Aesthetic Medicine Diploma(AAAM), a Diploma in HIV Management, Diploma in Tropical Medicine and Hygiene (University of the Witwatersrand, South Africa), Project Management Certificate, and Advanced Healthcare Management Course(Cum Laude) with FPD, South Africa. Beauty is passionate about Clinical and Aesthetic Dermatology; the ultimate goal being to offer a comprehensive solution to the entire skin health. She has presented papers and posters at national and international conferences. Beauty is a Chief Medical Officer with the Department of Health, and the Managing Director at Dermsthetic Medical Centre, Johannesburg, South Africa.
Erythema migrans – the characteristic rash of early Lyme borreliosis, wich is the most common tick borne infection in both North America and Europe. In Europe, 5 human-pathogenic genospecies from the Borrelia burgdorferi sensu lato complex have so far been isolated: B. afzelii, followed by B. garinii, B. bavariensis, B. burgdorferi sensu stricto and B. spielmanii. The Ternopil region, located in the western part of Ukraine, is an endemic area of Lyme disease. Habitats of the tick Ixodes ricinus were found in 57 settlements of the 15 districts in the vicinity of Ternopil. The study was based on 108 patients. The age of tested persons ranged from 18–74 years. The group of examined patients comprised 42 men and 66 women. Patients treated in Ternopil regional clinical dermatovenerologic dispensary. The diagnosis of Erythema migrans was established clinically according to the classification of ICD-10. A two-step algorithm consisting of ELISA and immunoblot tests (Euroimmun, Germany) was used in the study. During the first phase of the tests, presence of anti-Borrelia burgdorferi s.l. IgM/IgG antibodies were marked using ELISA method, and positive and uncertain results were confirmed by immunoblot (EUROLINE Borrelia RN-AT). Presence of specific antibodies IgM and/or IgG class to B. burgdorferi sensu lato (B. burgdorferi sensu stricto, B. afzelii and B. garinii) were detected in 85 (78.7 %) persons out of 108 serum samples studied, were 78 persons had detectable IgM responses alone, 3 – had IgG reactivity alone, and 4 of tested, had both IgM and IgG.
Shkilna Mariia received her medical degree from the Ternopil State medical University in 1991. Ph.D. (Skin and venereal diseases) from Kharkiv, SE Institute of Dermatology and Venereology of AMS of Ukraine in 2010. Dissertation: Clinical and pathogenic features of some types of urticaria and allergic dermatitis associated with lambliasis. She is a member of the Ukrainian Dermatovenereologists Medical Society and Ukrainian Infectious Diseases Medical Society and has published more than 150 scientific papers in Ukrainian and foreign journals
This research will contribute to develop and improve the management and diagnostic tools of skin cancer and other skin disorders such as lichen sclerosus. We have already developed a plausible method with multiphoton microscopy (MPM) which can be implemented for clinical investigations on basal cell carcinoma, a tool that can be used in order to develop a non-invasive, fast, cost-effective diagnostic method. Furthermore, we have showed that patients with genital lichen sclerosus could have higher risk to develop SCC, thus a regularly follow-up should be done as a prognostic measure. Furthermore, our goal is by using reflectance confocal microscopy (RCM) and MPM to develop painless, reliable method to examine the sensitive genital area affected with lichen sclerosus. Last but not leastwe try to develop an accurate methodology to screen for melanoma metastasis in the sentinel lymph nodes, overcoming the high workload and the limited histopathological examination of the tissue. A methodology allowing for instant 3D imaging of the intact lymph nodes will also contribute to a more sensitive analysis as larger parts will be investigated and potentially decreasing the risk for removal of healthy nodes. If successful, it will improve the value of lymph node diagnostics as a prognostic parameter, aid treatment planning and improve patient survival. Ultimately, the methodology can potentially be translated to metastasis screening for other cancer types, e.g. breast cancer.
Despoina Kantere is specialist in Dermatology and Venereology at the Sahlgrenska University Hospital in Gothenburg, Sweden. She is a PhD student at the Gothenburg University. Her research is non-invasive advanced laser microscopy techniques as diagnostic tools for skin cancer and lichen sclerosus. She has published articles in reputed journals and is co-author in scientific books.
Introduction: Ageing affects every cell in the body, but the skin shows the most obvious signs of the passage of time. In fact, during the aging process the skin becomes gradually thinner, drier with the loss of elasticity. Moreover, loss of volume in the face, due to both bone and fat loss, combined with the appearance of line and wrinkles, contribute to give a tired and older look. Combined treatment of High-Intensity Focused Ultrasound (HIFU) and Hyaluronic Acid (HA) anti-ageing injections, may be an effective and safe treatment to refresh the appearance. Objective: The aim of this study is to analyse the efficacy and safety of the combined treatment of high-intensity focused ultrasound (HIFU) and Hyaluronic Acid (HA) dermal fillers in skin/facial rejuvenation. Methods: The author proposes her combined protocol with HA and HIFU to treat facial skin. This aesthetic treatment was performed using HIFU technology (indicare caratteristiche) and HA dermal fillers with these features: a mix of cross-linked and non-crosslinked Resilient HA (RHA), 15 mg/ml concentration in total, 1.9% of BDDE and 0.3% of lidocaine; a 15 mg/ml non-crosslinked HA supplemented with a Dermo-Restructuring Complex (DRC, made with 14 compounds including specific vitamin, amino acid and antioxidant factors) and 0.3% of lidocaine. Moreover, patients’ photographs were taken before and after the treatments. Results: In this study was evaluated the efficacy and safety of HIFU and HA dermal fillers in the face. The author discusses her personal applications of these combined procedures and shows the results obtained using this combined aesthetic treatments. Conclusions: The combined treatment of HIFU and HA dermal fillers has proved to be an efficacy and safety option of aesthetic treatment. This combination approach produces a skin rejuvenation with an overall facial improvement appearance.
Cristina Sartorio did her Degree in Medicine and Surgery at the University degli Studi of Torino. During her course she have attended several refresher courses in aesthetic medicine, once graduated, she enrolled at the post graduation course in aesthetics and laser surgery at the “Agorà” institute in Milan and she have obtained a diploma in laser therapy. She is a member of the American Academy of Aesthetic Medicine and She constantly attend both local and international meetings that focus on aesthetic medicine,dermathology and anti-aging medicine.
Background: The study has been conducted in order to achive more effective results in lower third of the face by combining methods of aesthetic medicine in order to improve patients experience of aesthetic treatments, increase safety, and at the same time enable practitioner's to deliver more effective results. Methods: Using combinig techique applaying filler for voluminisation, PDO threads for structuring of the dermal layer of the skin and using mesotherapy, biococtails with strong concentration of hialuronic acids and aminoacids. Results: Total of 5 patients (all female) underwent intradermal injection, threads and mesotherapy cockatails for the facial enhancement of a number of face regions, process was repeated mothly. At the end of the follow up period of 30 days, the precision treatment reached the expectations of more than 93% of patients versus 85% in standard treatment. Conclusions: The result confirms it produces dramatic visible results and increase the satisfaction of patients, while reducing downtime, and time needed to deliver the effect patient expects. It reduces the overall costs for practitioner, by eliminating unnecessary visits.
Dr. Bijelic, graduated from the Medical faculty of Novi Sad, Serbia; specializing in Dermatology at Clinical Centre of Belgrade, Serbia. International KOL of Skintech Pharma group. Often speaks at regional an foreign congresses (IPAR, AMWC, ASKED, Day of Dermatology, Belgrade Dermatology Congress) in various subjects. Fluent in English. She works at Clinical Hospital Belgrade, Serbia.
This talk will review the new, WHO Classification of Melanocytic Skin Tumours, which reflects the most recent developments in dermatopathology including new entities. Importantly, there are significant changes to the classification of melanocytic tumors that include new entities and categories based on recent genetic information and clinicopathologic correlation. Reference Elder DE, Massi D, Scolyer R, Willemze R. (2018) WHO Classification of Melanocytic Skin Tumours, Fourth Edition, World Health Organization
Mary T. Parisi, MD is a board-certified Dermatopathologist who practices Dermatopathology in New York. She completed her fellowship in Dermatopathology at Cornell Medical Center and fellowship in surgical pathology, and residency in pathology, at New York University Medical Center, New York, NY. She received her MD from Drexel University in Philadelphia, PA and completed her pre-medical studies at Columbia University in New York, NY. Dr. Parisi has held academic appointments at SUNY Stony Brook (Clinical Assistant Professor of Pathology), Cornell Medical Center, NYU Medical Center and Hahnemann University Hospital and has also taught Dermatopathology to residents at NYU Winthrop Hospital and Nassau University Medical Center. She has authored several publications in peer review journals in the field of Dermatopathology. Her many outside interests include ballroom dancing, portrait drawing, and painting. She has wonderful memories of Italia, where, as an undergraduate in Firenze, she studied art history, and the Italian language and culture.
I will first give an introduction to cannabis and discuss the difference between hemp and cannabis. Then I will continue with a brief overview of what the endocannabinoid system is, and how it is involved in the skin. Next I will discuss the recent scientific studies behind cannabinoids and anti-aging, acne, itch, eczema, and psoriasis. I will include a summary of what products are already on the market, and where that market is projected to extend to.
Dr. Jacknin is a board-certified dermatologist, author, national speaker, and consultant, with expertise in holistic dermatology, natural cosmeceuticals, and topical hemp and cannabinoids for beauty and health. She is the author of the 400 pg. classic book Smart Medicine for Your Skin, published by Penguin Putnam in 2001. Dr. Jacknin has given over 45 national presentations at natural trade shows, dermatology, anti-aging, and cannabis conventions, and at Dermatology Grand Rounds. Dr. Jacknin became interested in hemp, CBD, and cannabis topically and in beauty and skin care in 2016. She has spoken at 9 international cannabis, anti-aging, dermatology, and pain conferences on the topic of the hemp, CBD, and THC in beauty and skin diseases. Dr. Jacknin was the first dermatologist to speak on the science behind topical cannabinoids and skin disorders at the Annual American Academy of Dermatology conference in February 2018. Dr. Jacknin is currently available as a professional cosmeceutical or CBD brand ambassador, consultant, and speaker.
Introduction: The Dendritic cell neoplasm Blastic Plasmacytoid (NCDBP) CD4/CD56 + is a rare hematological entity and highly aggressive, derived from plasmacytoid dendritic cell precursors. It occurs in adults, with cutaneous involvement as the first manifestation, and subsequent or simultaneous dissemination to bone marrow or peripheral blood. The histopathology is characterized by blastic appearance neoplastic cells, which infiltrate throughout the dermis to the subcutaneous tissue, without affecting the epidermal layer, and no reactive cell infiltrate. Usually no necrosis and desmoplastic reaction may occasionally be accentuated in the papillary and reticular dermis. Immunohistochemistry was characterized by the expression of CD4 +, CD56 +, CD2 + / -, CD7 + / - in the cytoplasm of the neoplastic cells. Others have recently been described as associated markers CD123 (IL-alpha Receptor 3) TCL-1 (T-cell leucemia/linfoma-1) CLA (cutaneous lymphocyte antigen associates) and BDCA-2 (Blood Dendritic Cell Antigen- 2). Median survival is 14 months, no significant difference in patients with cutaneous involvement with or without extracutaneous disease. Treatments have been used cyclophosphamide, adriamycin, vincristine and prednisolone (CHOP), which usually results in complete remission, but relapses back fast unanswered are the rule. There is one report of stable disease after use of antifolatepalatrexate, and has recently begun allogeneic bone marrow complete remission as a treatment. Case Report: Men 42 years of age with disseminated dermatosis, bilateral asymmetric, affecting scalp, face, neck on all sides, trunk, thoracic and pelvic limbs, consisting of macules and eritematoviolácasneoformations 2 mm to 3 cm diameter. These lesions began two years ago, with erythematous macules affecting face and nine months later increased in size and spread to the trunk and extremities. It was valued outside the Institute, where he performed with skin biopsy and diagnosis of CD20-positive NHL, received 6 cycles of chemotherapy using R-CHOP and 10 sessions of radiotherapy, with remission and exacerbation of injuries, so who reported on 2 different new chemotherapy occasions, and the recurrence presented for the third time, is referred to our hospital. Skin biopsy was performed, where the skin histology revealed infiltration by neoplasm blastic plasmacytoid dendritic cells (CD4 + / CD56 +). Lamellae immunohistochemistry Skin biopsy indicated by external CD123 +, CD43 +, CD2 +, CD56 +. CD4 + weak, CD7-, CD8-, EBER. Infiltration also found a bone marrow biopsy, lymph node and nasopharynx. The patient died two weeks after his diagnosis. Conclusions: It is important to consider NCDBP CD4 + / CD56 + in the differential diagnosis of hematopoietic tumors affecting the skin. Adequate diagnosis requires clinical suspicion for histological examination, immunohistochemistry including CD4, CD56, CD123 and TCL1, and the exclusion of myeloid markers. We report this case because of the rarity and special presentation by the prolonged course more than two years after its initial cutaneous manifestation.
Will be updated soon
INTRODUCTION: Dermoscopy shows much promise in the diagnosis of various skin disorders. This study was conducted to assess the usefulness of dermatoscopy in the clinical evaluation of different scalp and hair disorders. OBJECTIVES: To assess the usefulness of dermatoscopy in the clinical evaluation of various scalp and hair disorders. To establish the importance of new technique i.e. dermatoscopy in our dermatology department of Mysore Medical College and Research Institute. MATERIALS AND METHODS: A total of 200 patients who consented were studied for a period of 2 years (December 2015 to December 2017). Trichoscopy was performed with Dermlite DL3 dermoscope and lesions were evaluated for follicular and interfollicular patterns. RESULTS: Out of 200 patients, 102 patients were males and 98 were females. The mean age was 26.4 years. The most common disorder seen was alopecia areata (29%) followed by tinea capitis (14%). The most common dermoscopic findings were broken hairs (35%) and short vellus hairs (34%). Characteristic dermoscopic findings of alopecia areata were tapering hairs, short vellus hairs, yellow dots and black dots. Androgenetic alopecia showed specific findings like hair diameter diversity and empty follicles. Trichotillomania on dermoscopy showed broken hairs of different lengths, black dots, v-shaped hairs and microhaemorrhages. Comma hairs, broken hairs and corkscrew hairs were found in tinea capitis. Scalp psoriasis had silvery white scales, red dots and globules whereas seborrhoeic dermatitis showed yellowish scales and arborising vessels on trichoscopy. Primary cicatricial alopecias were characterized by dermoscopic findings of lack of follicular ostia. Furthermore, follicular plugging and arborising vessels were specifically seen in discoid lupus erythematosus. Folliculitis decalvans specifically showed tufted hairs and “star burst sign” on dermoscopy. DISCUSSION: Dermoscopy is a simple, easy to use, relevant diagnostic tool in the evaluation of scalp and hair disorders both for differential diagnosis and prognostic purposes.
Dr JOICE MARIA JOSEPH has completed M.D from Mysore Medical college and Research institute in June 2018. Has presented award papers and posters in various national and international conferences. Has published articles in international and national journals. Has recieved EADV fellowship to attend EADV congress, PARIS, 2018.
Melasma is an acquired and chronic hyperpigmentation on sun exposed areas. The aim of this study isdetermining the prevalence of melasma during pregnancy and the triggering factors associated.Methods: A cross-sectional study was carried out by clinical examination and questionnaire on 512 puerperal women between January 2015 and January 2016. Women, who develop melasma before pregnancy and with other causes for facial hyperpigmentation, were excluded.Results: The mean age of the 218 enrolled patients with melasma was 27 (± 6) years old. The prevalence of melasma was 42%. centrofacial pattern was seen in 47.2 %, whereas 38.5% of the patients had a malar pattern and 11.3 % had a mixed pattern. Positive family history of melasma was present in 58.4% of the cases. There was a statistically significant relation between melasma and sun exposure in childhood (p=0.01). Age at the first pregnancy (with melasma 27 ± 6 vs without melasma 22.4 ± 5.2, p=<0.01), number of parity (with melasma 2 (±1) vs without melasma 1.8 (± 1.3), p=0.01). Low grade scholarship education and living in the rural areas were significant risk factors when compared with women without melasma (p=<0.01). The 36.6% (n=80) of the women, associated their melasma with pregnancy.Conclusion: Our study confirms that almost half of Mexican pregnancy women develop melasma. The disease appears mainly at the third trimester.
The Dr. Israel Esquivel is graduated of dermatologist from Hospital Central "Adolfo Prieto", with a specialization in dermatopathology by the Hospital General "Dr. Manuel Gea González" in Mexico City. He also has a fellowship in tropical dermatology in the Hospital de Clínicas de la Facultad de Medicina de la Universidadde Sao Paulo (HCFMUSP). He is currently director of the clinic DERMATOS in Torreón, México.
Skin aging is a progressive process determining the ultimate skin appearance. This complex biological phenomenon is influenced by a combination of endogenous and exogenous factors, particularly by solar UV radiation, known as photoaging. The deleterious effects of UV are both direct and indirect. The indirect effects are due to the production of reactive oxygen species that may cause; cellular, extracellular and membrane structural damages; increasing release of pro-inflammatory mediators from a variety of skin cells; and induction of an inflammatory infiltrate. The increase of skin cells induces the degradation of a variety of proteins such as collagen and elastin as well as hyaluronic acid by collagenase, elastase and hyaluronidase. The search for natural compounds inhibiting these enzymes is thus the current task. Plants in general and especially algae contain a variety of active metabolites for the wellbeing of the skin. The present work demonstrates the kinetic study of the main enzymes responsible for skin macromolecules degradation. Therefore, kinetic studies of human neutrophil elatase, bovine hyaluronidase and matrix-metalloproteinase-1 were done by miniaturized assays developed by capillay electrophoresis. These assays were developed either outside the capillary (which serves only as a separation tool) or in the capillary (which then serves as an enzymatic nanoreactor) then optimized to allow the determination of kinetic constants (Km, Vmax and IC50). Detectors such as laser-induced fluorescence or high-resolution mass spectrometry have been coupled to capillary electrophoresis to achieve high sensitivity detection and the possibility of identifying the products of the enzymatic reaction. The extraction of Padina pavonica, a brown alga and Jania rubens, a red alga was performed using several green techniques and the effect of the extracts was studied. The results revealed a strong interaction between the crude extracts and the enzymes collagenase, elastase and hyaluronidase. Such assays proved to be reliable, robust and economically feasible. They will be further utilized to evaluate the biological activity of extracts from plants and algae towards skin enzymes in addition to whole cell assays for cosmetic and therapeutic applications.
Syntia Fayad has completed her PhD from University of Orleans where she worked on the Development of high-performance tools for skin enzymatic screening of natural products by capillary electrophoresis » at the Institute of Organic and Analytical Chemistry. She is currently doing a postdoctoral at University of Bordeaux at the Science Institute of Vine and Wine. She has published more than 8 papers in reputed journals and has 1 pending patent applications.
We know that solar radiation is the main cause of skin aging by generating oxidative stress and DNA damage that causes loss of extracellular matrix integrity and fibroblast changes. In addition, there is also a decrease in TGF beta and FGF2, thus reducing the production of collagen causing sagging and skin wrinkles. Platelet-rich plasma (PRP) is a platelet derivative obtained by autologous blood centrifugation that contains several growth factors that are fundamental in the tissue modulation and regeneration, whereas plasma proteins act as a scaffold for epithelial migration. PRP stimulates fibroblasts by biostimulation, making the biological precursors available for extracellular matrix formation. It performs tissue repair and stimulates fibroblast synthesis by maintaining a neutral pH. Its stimulus starts after 10 days, with effect for up to 3 months. Several scientific studies have demonstrated the therapeutic efficacy of PRP in the production of new fibroblasts as well as in the stimulation of collagen, elastin and proteoglycans, reducing wrinkles and improving skin’s barrier, hidratation and antioxidant system. PRP can be used to facial rejuvenation of both the epidermis, bone loss and fatty tissue, harmoniously redefining the face.Facial rejuvenation may be associated with photodynamic therapy – a minimally invasive technique and current trend for facial rejuvenation –by using methyl 5-ala in low doses that stimulates collagen and cutaneous fibroblasts, reducing wrinkles, sagging, staining and reducing the risks of non-melanocytic skin cancer, without significantly damaging the epidermis and dermis and without removing the patient of social interaction. The association of these two techniques for facial rejuvenation is a way of harmonizing the face with less invasive methods for the patient.
Flavia Nakamura M.D. is postgraduate degree in Dermatology, Medical Aesthetics, Nutrology and Orthomolecular Practice. She is Director of the Brazilian Medical Association of Orthomolecular (AMBO), Member of the Portuguese Society of Aesthetic Medicine and Anti-Aging (SPME). She is a guest professor of Dermatology and Aesthetics at the postgraduate course in Integrative Medicine at the Fernando Pessoa University, Porto (Portugal) Coordinator of the postgraduate course in Neuroendocrinohormonal Biochemistry Associated with Aging at Fapes (2016) and postgraduate professor in Orthomolecular Practice (Fapes / Ambo | Isbrae-Asime) She is the author of the book “PRP: Rich Plasma in Platelets”, in partnership with Dr. Efrain Olszewer and Dr. Emil Arroyo.
The forehead tends to lose volume with ageing due to loss of subcutaneous fat, bone resorption, as well as thinning of the muscles and skin. This causes flattening or concavities to form in the forehead and the bony outline of the skull to become more evident. Furthermore, the loss of volume can tend to increase the propensity of the skin to wrinkle with contraction of frontalis (forehead muscle). Replacement of lost volume is best achieved by using dermal fillers or fat transfer. These can be strategically placed to improve volume of the forehead, and to recreate a more convex and youthful appearance. Revolumisation provides resistance to skin creasing, and brow support.
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