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IMCAS Asia 2019
Program

FOCUS ON S059

Clinical dermatology - Rosacea: anything new?

Room: Room 3A
Date: Saturday 6 July 2019 at 11:00 to 12:00
Format: FOCUS SESSION > lectures covering a major topic of the congress
Objectives: 1. Describe the features of rosacea and mechanisms underlying it 2. Explore innovations in treatment options for rosacea 3. Formulate a successful plan to treat facial redness using a combined approach

Chairs

Dr Pin Chi CHIU

Dermatologist

Taiwan

Dr Anurag TIWARI

Dermatologist

India

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
11:00	Dr Evgeniy SHAGOV	Rosacea - New opportunities in the treatment of the old problem	View	70433
11:12	Dr Victor Gabriel CLATICI	Rosacea and laser - Specific approach according to clinical types	View	85642
11:24	Prof Chee Leok GOH	Management of facial erythema and telangiectasia	View	84722
11:36	Dr Kar Wai Alvin LEE	Intense pulsed light for the treatment of rosacea resistant to doxycycline and metronidazole gel	View	86825
11:48		Questions and answers		88186

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Rosacea

Lights (IPL, UV, IR, LED...)

Lasers

Vascular lesions

Energy-based devices (EBD)

Dr Evgeniy SHAGOV

Dermatologist

Ukraine

Other author(s) :

Rosacea - New opportunities in the treatment of the old problem

Objectives: Rosacea - a widespread pathology (5% dermatoses). It occurs in all skin phototypes. Erythema is less pronounced in people with IV, V and VI skin phototype. Women are impacted in more often than men. Rhinophyma, gnatofima etc. are more common in men.

Introduction: This is a disease that has multiple etiopathogenetic mechanisms. Traditionally, there are several stages of this dermatosis. Effective therapy is possible only when taking into account the factors listed above.

Materials / method: For 15 years we have been using various methods and technologies of rosacea therapy in the clinic. During this period, thousands of patients were treated. By assessing the objective and subjective data characterizing the results of therapy, today we can identify the most effective of them.

Results: The basic principles of rosacea treatment - patient education, skin care, treatment - remain relevant to this day. With the right choice of strategy, success in therapy can be more than 80%. The use of vascular lasers and IPL-therapy significantly increases the effectiveness of therapy.

Conclusion: Rosacea - a disease with various clinical manifestations. It has a multiple trigger factors.
DISEASE CONTROL = EDUCATION + SKIN CARE +THERAPY.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Victor Gabriel CLATICI

Dermatologist

Romania

Other author(s) :

Rosacea and laser - Specific approach according to clinical types

Objectives: Rosacea represent a chronic relapsing inflammatory skin disease, with an increasing prevalence (generally under-diagnosed and often overlooked), and multiple risk factors (genetics, age, phototype, alcohol consumption and ultraviolet exposure).
Rosacea is frequently associated with systemic diseases (neurologic and cardiovascular disorders, diabetes and metabolic disorders, autoimmune diseases and digestive disorders) and have an important negative impact on quality of life (anxiety, depression, embarrassment, frustration, social and professional isolation etc.).

Introduction: The cause of rosacea is still unknown but abnormalities in immune system (both innate and adaptative) and neurovascular status are implicated in pathophysiology.

Patients with rosacea present disruption of epidermal barrier, increased expression of TLR2 (associated with increasing production of IL-8, IL-1β, and TNF-α), and activation of KLK5 - Kallikrein-5 (which upmodulate production of cathelicidin LL – 37 = effects on immune modulation and inflammation).

Materials / method: Patients with rosacea present dysregulation in adaptative immunity, both in T cell mediated response and B cell mediated response.

The management of rosacea need an holistic approach, with diet and skin care (including photoprotection and cosmetic camouflage), local and systemic treatment, and EBD – Energy based Devices approach.

Some of the most efficient drugs used are characterized by immune modulation properties, like topical azelaic acid, doxycycline (including sub-antimicrobial-dose) and macrolides.

Results: Laser treatment (Pulsed Dye Laser – PDL and Nd-YAG 1064nm) have a lot of effects, like ablation of vascular anomalies (destroy small vessels and reducing the symptoms), reorganization and remodeling of dystrophic dermal connective tissue and interruption of the release of inflammatory mediators.

Conclusion: Rosacea is a frequently chronic inflammatory skin disease, and immunity, both innate and adaptative, plays an important role in rosacea pathogeny. Holistic approach (education, skin care, local and systemic treatment, vascular laser and nanotechnology) is the best ways to treat the patients. Immunomodulation by local and general treatment, laser surgery and nanotechnology will be the future.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Prof Chee Leok GOH

Dermatologist

Singapore

Other author(s) :

Management of facial erythema and telangiectasia

Objectives: This presentation outlines the common causes of facial erythema and telangiectasis which are amenable to treatment and their treatment modalities

Introduction: Red face or couperosis (a French term) refers to patients having red/coppery lesions on the nose and face. It signifies small dilated superficial blood vessels. It is often described in patients with rosacea where visible vessels often observed. But there are multiple cause of telangiectasia. The dilatations of the blood vessels may appear as small angiomatous spots, spider angioma or as telangiectatic threads.

Materials / method: The treatment of choice is elimination of the dilated vessels with vascular lasers. However, as the dilated vessels (due to various causes) varies in size, colour, depth, density and characteristics and the overlying skin varies in thickness, location and skin colour, the choice of vascular lasers becomes critical to ensure effective ablation.

Results: The pulsed dye laser is the vascular laser of choice in couperosis as it operator to adjust the fluence, pulse duration and spot size to the optimal parameters. The disadvantage is the purpura it may cause if short pulsed duration are used. Other vascular lasers that can be used in couperosis are the KTP 532nm lasers for superficial lesions, IPL(500-1200nm), long pulsed Nd:YAG(532/1064nm) lasers, long pulsed Alexandrite (755nm) lasers, long pulsed Diode lasers.

Conclusion: Most of the facial vascular lesions respond well to laser or light treatment but recurrence is common. Retreatment can be carried out should recurrence occur.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Kar Wai Alvin LEE

Hong Kong SAR China

Other author(s) : CH Lee, KW Chan, KF Lee

Intense pulsed light for the treatment of rosacea resistant to doxycycline and metronidazole gel

Objectives: Intense pulsed light for the treatment of rosacea resistant to doxycycline and metronidazole gel

Introduction: Background Rosacea is a chronic disease that affects the skin aesthetic appearance. Doxycycline is the first line oral medication to treat rosacea, while metronidazole gel is the first line topical medication to treat rosacea. There are patients who are resistant to both treatments.

Materials / method: 3 cases with oral doxycycline and metronidazole gel treated rosacea patients were referred by other doctors were studied. All 3 of them received 8 sessions of IPL treatment in a 4 weekly interval. Clinical photos were taken in every visits. Two individual blinded investigators were asked to assess and compare with the pretreatment photos.

Results: Results There were significant clinical improvement in the erythema, telangiectasia, number of papules and pustules. Patients were satisfied after the treatment.

Conclusion: This study suggests IPL is effective in improving the erythema, telangiectasia, number of papules and pustules, despite the patients were resistant to oral doxycycline and metronidazole gel.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS Asia 2019 Program

FOCUS ON S059

Clinical dermatology - Rosacea: anything new?

Chairs

Lectures of the session

Recommended sessions

IMCAS Asia 2019
Program