Day 2 :
St. Marianna University School of Medicine, Japan
Tamihiro Kawakami has completed his MD from Chiba University School of Medicine, Chiba, Japan in 1989. He has then started his research on growth factors in systemic scleroderma at the Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, USA, which led to his PhD in 1998. He was a Resident at the Department of Dermatology, Chiba University School of Medicine, Chiba, Japan in 1989. He was a Staff Dermatologist at the Second Department of Dermatology, Toho University, Tokyo, Japan in 1992 and was a Visiting Research Fellow at the Department of Cell Biology and Anatomy, University of Miami School of Medicine, Miami, USA in 1995 and at the Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, USA in 1996. Since 2015, he has been an Associate Professor at the Department of Medical Genetics, St. Marianna University.
Unilateral nevoid telangiectasia is characterized by the unilateral and dermatomal distribution of telangiectasia. This rare disorder is believed to be related to increased estrogen receptors in the involved skin. A 12-year-old Japanese girl had a progressive unilateral nevoid telangiectasia that began six years earlier on her left leg and foot. Examination revealed numerous wiry and spidery telangiectases of her left lower extremities. She had normal blood estrogen levels. A skin biopsy revealed only dilated blood vessels in the superficial dermis. Tissue specimens from the macules revealed no expression of estrogen receptors. Unilateral nevoid telangiectasia is a unique vascular dermatosis of ambiguous etiology. Our patient did not have any disease induced by an estrogenized pathological state during the four year follow-up period after her initial examination. We propose that unilateral nevoid telangiectasia may result from localized trigger factors based on a chromosomal mosaicism, independent of an abnormal hormonal state.
- Allergology l Genodermatosis l Skin Cancer l Warts and Vitiligo l Diagnostic Techniques in Dermatolog
Queen Medical Center, Qatar
Queen Medical Center, Qatar
The frequency and severity of atopic disease is increasing in Qatar. We have aimed to determine characteristics of patients with severe forms of atopic asthma, rhinoconjunctivitis and atopic dermatitis in adult Qatari and non-Qatari residents who presented at Queen Medical Center, Doha from January 2015 to May 2016. A total of 31 adult patients (11 males) with severe atopic conditions attended outpatient clinics and ER during the defined period. Among the patients, 5 (16.1%) were Qatari and 26 (83.9%) were non-Qatari [11 (35.5%) Arabs, 7 (22.6%) Caucasians, 7 (22.6%) Asians and 1 (3.2%) African]. A family history of atopy was present in 17 (54.8%) patients with asthma the most common conditions reported (in 12 patients; 38.7%). Severe asthma was diagnosed in 14 (45.2%) patients, severe rhinoconjuctivitis in 11 (35.5%) and severe atopic eczema in 6 (19.6%). Overall, 21 (67.7%) patients had one severe atopic condition while 10 (32.3%) had other atopic manifestations as well with severe rhinoconjuctivitis commonly associated with asthma. Only three of the patients surveyed had all three of these atopic conditions. Eight patients (25.8%) reported that the condition had an onset or worsening in adulthood; in seven of them, it was coincident with residency in Qatar; possibly related to the local environment or climate. Generally, dust was mentioned as the most common trigger factor, followed by pollens and grass, strong smells and animal dander. Patients with severe atopic dermatitis were likely to have allergies other than classic atopy; penicillin allergy, food allergy and contact dermatitis (each reported in 2 patients). Our findings indicate that severe atopic disease is an important public health problem in Qatar. There will be a need for improvement in prevention and management plans.
Enas Attia has completed her MD in Dermatology and Venereology in 2006 in the Faculty of Medicine, Ain Shams University in Cairo, Egypt. She is currently a Dermatology Consultant and Head of Dermatology Department, Queen Medical, Qatar and an Associate Professor of Dermatology, Venereology and Andrology, Faculty of Medicine, Ain Shams University, Egypt. She has published more than 30 papers in reputed journals and has been serving as a Reviewer and an Editorial Board Member of repute.
King Abdullah Bin Abdulaziz University Hospital, KSA
Abdulaziz H Al Hussain has completed his Medical School at King Saud Bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia in 2013. Currently, he is enrolled in King Saud University for Dermatology Residency Training Program. He has attended and contributed in many dermatological researches and scientific meetings.
Aquagenic Wrinkling of the Palms (AWP) is a rare dermatologic disease. It was first described four decades ago as a potential test for Cystic Fibrosis (CF) by detecting “skin wrinkling” in response to water immersion. We are reporting two cases of AWP diagnosed at Derma Clinic, Riyadh, Saudi Arabia. The first case was a nine year old girl and the second case was a 17 year old adolescent male. The second case was associated with palmer hyperhidrosis. Both patients denied any medication use. Additionally, signs and symptoms suggesting CF were lacking. Local dermatologists should be aware of rare conditions such as AWP and lack of previous reports from the region may indicate under-reporting rather than lack of cases.
Aga Khan University Hospital, Pakistan
Arshalooz J Rahman is a graduate of Dow Medical College Karachi, Pakistan. She has completed her Residency from Brookdale University Hospital in Pediatrics and Fellowship in Clinical Pediatric Nephrology from Stony Brook University Hospital, USA and Diploma in Health Professional Education from Aga Khan University. She is Diplomate American Board of Pediatrics and presently working at The Aga Khan University Hospital in the Department of Pediatrics and Child Health. Her clinical and academic interest is in general pediatrics, pediatric nephrology and medical education. She is the Training Supervisor for FCPS and MRCP candidates at her institute and Examiner for postgraduates at College of Physicians and Surgeons, Pakistan.
Background & Aim: Stevens-Johnson syndrome (SJS) is one of the most dreaded drug related complication leading to extensive mucocutaneous involvement in severe cases and long term complications. This group of disease is related to certain medication groups however we report a substantial number of non-drug related cases as well. The aim of this study was to look into various causes and outcome of SJS in children presenting to our institute.
Method: A 10 year retrospective review was done on all the cases coming to the Aga Khan University Hospital, variables like etiology, clinical characteristic, treatment and outcome were entered on a predesigned profoma and frequencies were analyzed on SPSS 17.
Results: Total sample size of 97 patients was analyzed; 69 patients presented with generalized rash (more than 10% of body involvement with mucositis) and 12 had localized disease (less than 10% skin involvement) 16 patents were categorized as in between category. Exposure to drugs 77 (79.4%), 20 (20.6%) cases were categorized as non-drug related. Out of drug group 52% were exposed to antibiotics, 22% were given antimalarial and 10.5% were given antiepileptic medication. Among the therapeutic interventions intravenous steroids were given 30%, IVIG 2% either alone or in combination rest were managed with supportive care. 23.7% developed systemic complications (AKI 12.6%, sepsis 46%, Pneumonia 13%, and one case developed ocular complication while in hospital. Outcome was classified at the dime of discharge fully resolved 10.6%, partial resolution 71%, mortality 14.4%.
Conclusion: Drug related dermal complications like SJS are predominantly attributed to antibiotics, antimalarial and antiepileptic drugs however non drug related presentations also contribute to significant number of cases. Delay in recognition leads to systemic complications morbidity and mortality if not treated on time.
Aldent University, Albania
Edlira Neza has completed his PhD from University of Siena, Italy in Pharmaceutical Sciences (with e section in cosmetic science) and her undergraduate studies at the University of Tirana. Her research interest is in the area of cosmetic science. She has published several papers in European journals. She is currently a Lecturer in the Department of Pharmacy Aldent University, Albania and also has an interesting experience in pharmaceutical industry.
Skin lightening products are widely used by people with hyperpigmentary skin disorders. The most effective molecules used in these products were hydroquinone, mercury and corticosteroids. These chemical compounds are banned to be used in cosmetic products because they can be harmful to human health. We investigated the Rapid Alert System (RAPEX) database from January 2005 until December 2014 to give information about the safety of skin lightening products in European markets. 124 cosmetic products contained hydroquinone in concentration from 0.06 to 7.1%. Hydroquinone was found in skin lightening products (90.32%) body lotions, (8.06%) body oils (0.81%) and hair creams (0.81%). The country of origin of the products was Democratic Republic of Congo, Ivory Coast, United States, France, United Kingdom, Poland, Germany, Belgium and Jamaica. A large number of cosmetics were contaminated by heavy metals: Lead, mercury, antimony, chromium, cadmium, arsenic and nickel. In 45 cosmetic products mercury was present in skin lightening products in concentration from 9.1 mg/kg to 42000 mg/kg. Lead was found lipsticks, make-up, children products in concentration up to 16900 mg/kg. Skin lightening products with clobetasol propionate were also recalled during the period. As a conclusion we can say that people with hyperpigmentary skin disorders are exposed by the risk of chronic use of prohibited chemical compound in skin lightening products.