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IMCAS World Congress 2022
Program

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FOCUS ON S011

Contributing lectures - Clinical dermatology & dermatologic surgery

Room: Room Passy - Level 1
Date: Friday 3 June 2022 at 08:30 to 10:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Muriel CREUSOT

Dermatologist

Belgium

Dr Marie JOURDAN

Dermatologist

France

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
08:30		Introduction		112426
08:32	Dr Amr RATEB SAID	Acne scars: pathogenesis, prophylaxis, and management	View	113022
08:50	Dr Mauricio Orlando MENDEZ ESPANA	Granuloma by PCL biostimulator and its management	View	113178
08:59	Dr Emmanouil DIMONITSAS	The 3-step Greek protocol for neck skin rejuvenation, as inspired by a woman with pseudoxanthoma elasticum	View	114315
09:08	Dr Michel PASCAL	Is the non cultured epidermal cell graft the treatment solution for vitiligo	View	116262
09:17	Dr Nenad STANKOVIC	Can we have an effective treatment of hyperpigmentation with natural ingredients?	View	115024
09:26	Dr Victoria G BELO	Intradermal air dissection and fractional microneedling with radiofrequency in the treatment of severe atrophic acne scars in Asian skin	View	116834
09:35	Dr Omnia KHATER	Acne scars: triple treatment	View	116836
09:44	Dr Fiorella DERIU	Fractional peeling	View	116842
09:53		Q&A		114316

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Recommended sessions

Scars

Microneedling

Combined treatments

Lasers

Photoaging

Introduction

Dr Amr RATEB SAID

Dermatologist

Egypt

Other author(s) :

Acne scars: pathogenesis, prophylaxis, and management

Objectives: Tips and advice that should be given to the patients to avoid scar formation in acne and simple affordable techniques that doctors can use to help their patients.

Introduction: Acne affects almost 85% of people between the ages of 14 and 25 worldwide. It can persist to the age of 45 in 12% of females and 5% of males affected. Scarring is the ultimate result in severe inflammatory acne, but can also occur in moderately or non inflammatory lesions. Scars, stay for life and affect the patients emotionally if not treated.

Materials / method: Understanding the pathogenesis of scarring in acne is crucial for both the patient and the doctor if we want to try to prevent it from happening.
I will also, introduce my experience in treating acne scars of different types and shapes with a combination of techniques that are affordable and with results comparable to those obtained by the most advanced and expensive medical machines.

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 Mauricio Orlando MENDEZ ESPANA

Mexico

Other author(s) :

Granuloma by PCL biostimulator and its management

Objectives: Report of a case, granuloma secondary to the application of PCL a biostimulator
the importance of knowing that we are injecting will guide us in the treatment to be carried out to reverse adverse effects

Introduction: Polycaprolactone (PCL) is a biodegradable aliphatic polyester, the polymer is frequently used and has its medical indications such as volume replacement and collagen biostimulator, it belongs to the group of semi-permanent injectables. PCL is degraded by hydrolysis of its ester linkages under normal conditions; measured by different enzymes that are capable of hydrolyzing products and breaking their hydrogen bonding structure. Today we know that this material is combined with carboxymethylcellulose 70% of the material and 30% PCL, which this osmotic carbohydrate serves as a vehicle for the PCL

Materials / method: Case report

A 48-year-old female patient comes to our clinic, referring that she had been placed with PCL with another dermatologist. A clinical history is started and data is collected to initiate ideal management, as the patient had more than 3 months of application of PCL, she refers that from the beginning of the product, when it was placed, she noticed a few days later that it was stiff, very little mobile, At 6 weeks after product placement, it begins with total deformation, inflammation and increased volume of the PCL placement sites.

Results: General data is taken, for which we decide and due to evolution time we suspect a reaction to the product and the generation of collagen worsened the situation. Therefore, we started under the protocol Biopsy of the area and extraction of little material; which is made by Dra. Rebeca Palacio; retinologist and Dr. Juan Biguerias, surgeon and esthetician; due to the proximity to risk areas for compromising the orbit, corrugator muscle, and proximity to the temporal nerve. Extracted material is sent to the pathology laboratory for study and a photographic count is taken

Conclusion: They send us a pathology report showing the following:
Report: Epithelioid histiocytes, multinucleated giant cells; foreign body, lymphocyte collar and abundant fibrosis at the site of placement
The management of a patient with this deformity is not so easy, it is a challenge for every dermatologist, aesthetic doctor, plastic surgeon, for which, given the data revealed by the biopsy, we started with 5ml collagenase on each side injected intralesionally with a 25G dermal cannula with technique of subinscision.

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 Emmanouil DIMONITSAS

Plastic Surgeon

Greece

Other author(s) :

The 3-step Greek protocol for neck skin rejuvenation, as inspired by a woman with pseudoxanthoma elasticum

Objectives: We herein present a combination of three different therapies (laser skin resurfacing, type I horse collagen boosters and platelet rich plasma) as an approach to ameliorate neck skin sagging.

Introduction: The physiological ageing process causes significant changes in the extracellular matrix (ECM) of the neck skin, which are the first signs of ageing witness for women. We are inspired by a young woman, who suffers from a rare genetic disorder called pseudoxanthoma elasticum (PXE), which manifests irregular, thickened, fragmented and haphazardly orientated elastic fibers.

Materials / method: A 28-year-old Roma woman underwent 3 sessions of this protocol every 3 weeks. Clinical assessment supported by photographic documentation was performed at each session. One month after the last treatment session, a new biopsy was taken.

Results: Severe changes in hydration and tightening of the neck skin were obvious 3 weeks after, although the verification of the results was substantiated with the pathology of the post treatment skin biopsy obtained 1 month following the completion of the protocol. The elastic fibers in the mid-dermis were dense, non-fragmented and parallel oriented. The aesthetic performance was evident 12 months after.

Conclusion: Nowadays, the primary goal of aesthetic medical research is oriented to the dermis bio-reconstruction, where specific treatments are combined in a way of fibroblast stimulation.

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 Michel PASCAL

Dermatologist

France

Other author(s) :

Is the non cultured epidermal cell graft the treatment solution for vitiligo

Objectives: Vitiligo is an acquired disorder of depigmentation. As soon as immune attack on melanocytes is halted, epidermal graft may be proposed for recovering pigment.
We know two major clinical types: segmental vitiligo(unilateral) which stabilizes spontaneously within the first or second year of onset and the bilateral one which is spreading for several years. Only a minority with generalized vitiligo are suitable for graft.
This study will specify the best indications of melanocytes graft, their limits and will analyse the quality of repigmentation on treated areas and durability over several year

Introduction: Stable vitiligo (no appearance of new lesions, no increasing in size of old lesions or no Koebner ) may be unresponsive to medical treatment.Local corticotherapy and UVB are less efficient on segmental vitiligo. For these cases, surgical intervention seems to be the solution to facilitate repigmentation. Procedures have been developed such as the punch graft, suction blister graft, split thickness skin graft, cultured melanocytes or non cultured epidermal cell (NCEC). The interest of NCEC is the ability to cover large areas, with good cosmetic outcome and most of time excellent color match.

Materials / method: 82 patients with stable vitiligo for at least 6 months were proposed to receive a NCEC graft. A biopsy of healthy thin skin is treated with trypsin to get an epidermal cell suspension mixed with hyaluronic acid. A dermabrasion of the lesions is realized with CO2 laser.The suspension is deposited onto the abraded areas. An occlusive bandage is applied during 4 days. 2 weeks after a phototherapy is undertaken twice a week during 6 months. Images were taken each month. Repigmentation rate was calculated by Image J, quality of repigmentation, safety and patient global satisfaction were documented.

Results: Eighty two patients 8 to 66 years old have been observed from 2013 to 2021: 46 patients with segmental and 36 with bilateral vitiligo.
75 % lesions located on the face (lids, cheeks,forehead, lips) have excellent results (70-93% treated area) . 36 have more than 70% pigmented area in segmental vitiligo, only 10 patients with the same score in bilatéral vitiligo.
16 patients had moderate pigmentation ( 50-60%)
20 patients had poor pigmentation less than 30%
3 patients have noticed hyperpigmentation on the lesions of face. 10 patients showed hypopigmented border around grafted areas.

Conclusion: Segmental vitiligo is often unresponsive to medical treatment as local corticosteroides, tacrolimus and UVB but his early stabilization (2 years max) and the low frequency of recurrences, let us consider that this clinical type is the best indication for non cultured epidermal cell graft. In addition the quick healing and the minimal scar risk are an advantage beside punches or split thickness skin graft. NCEC can be used for non segmental vitiligo to recover rapidly the pigment but we will have better results if we can prevent recurrences with the new biotherapies as the antiJAK.

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 Nenad STANKOVIC

Stomatologist

Serbia

Other author(s) :

Can we have an effective treatment of hyperpigmentation with natural ingredients?

Objectives: Gathering information through clinical studies that are evaluating the use of different natural products in treating. Specific ingredients reviewed include azelaic acid, aloesin, mulberry, licorice extracts, lignin peroxidase, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, and ascorbic acid.

Introduction: Hyperpigmentation disorders are commonly encountered in patients that are visiting aesthetic clinics. Botanical and natural ingredients have gained popularity as alternative depigmenting products.

Materials / method: Searches of PubMed databases were performed using the various ingredient names, "melasma" and "hyperpigmentation".

Results: Several natural ingredients showed efficacy as depigmenting agents, including azelaic acid, soy, lignin peroxidase, ascorbic acid iontophoresis, arbutin, ellagic acid, licorice extracts, niacinamide, and mulberry.

Conclusion: The aforementioned ingredients show promise as natural treatments for patients with hyperpigmentation disorders. These agents might also provide clinicians and researchers with a way to further characterize the pathogenesis of dyschromia.

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 Victoria G BELO

Dermatologist

Philippines

Other author(s) : Princess Czaronne Odita, MD, Jawn Pe- Saldajeno, MD, Guada Santos-Capiz, MD, Michelle Villanueva, MD

Intradermal air dissection and fractional microneedling with radiofrequency in the treatment of severe atrophic acne scars in Asian skin

Objectives: To determine the safety and efficacy of using Intradermal Air Dissection and Fractional Microneedling with Radiofrequency for the treatment of severe atrophic acne scars in Asian patients.

Introduction: Asian skin has been observed to be prone to complications, alongside this is the challenge in treating atrophic acne scars, which affects quality of life. Several treatment modalities are availablein the market. Fractional microneedling with radiofrequency (FMRF) is a combination therapy which creates multiple microinuries and heats the dermal layer, eliciting wound healing response and subsequently, neocollagenesis. Intradermal air dissection acts like subcision, where a small amount of air is injected to release the fibrotic bands underlying the scars.

Materials / method: Ten healthy patients aged 20-40 years old with Fitzpatrick skin type IV, and severe acne scarring according to Goodman and Baron’s Qualitative Acne Scar Scale were enrolled in the study. Each patient received 3 treatments, with 4-6 week intervals between treatments. Digital photos and 3D imaging were taken before the procedures, and 1 month after the final treatment. Topical anesthesia was applied prior. Intradermal air dissection using G32 needle was done on one side of the face, followed by FMRF. The other side of the face was treated with FMRF alone.

Results: Based on the 3D imaging tool and software, the average improvement on the
side where FMRF was done was 30-40%. On the other hand, the side where intradermal
air dissection and FMRF was done showed an average scar improvement of 50-
60%. The third-party observer using Goodman and Baron’s Qualitative Acne Scar Scale showed improvement from severe to moderate level of acne scarring. There were no reported adverse reactions such as burns, hypo/hyperpigmentation, and scarring. Patients have subjective reports on pore tightening, less sebum production, reduction of fine lines, and skin tightening.

Conclusion: Fractional microneedling with radiofrequency is safe and effective in treating severe atrophic acne scars in Asian patients. Combining it with intradermal air dissection increases the improvement of the scars.

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 Omnia KHATER

Dermatologist

United Arab Emirates

Other author(s) :

Acne scars: triple treatment

Objectives: Scars is the most challenging skin problem that annoy most of patients
Combine treatment the best solution and curable for scars
The outcome is different and depends on patient skin type, scars type and depth of scars
Different modalities are effective in making the scars look better for example resurfacing laser, subsesion, growth factors, micro, punch excision, needling, RF, threads and biostimulator
My experience is the combined treatment is the best and moreover what the doctor starts 1st depending on his experience and knowledge of healing steps

Introduction: Scars is the most challenging skin problem that annoy most of patients
Combine treatment the best solution and curable for scars

Materials / method: Resurfacing laser ablative and non ablative
Subsesion needle
Punch
Threads
Injectables

FIRST STEP OF TREATMENT Subcesion under local aesthesia(cross TCA or punch biopsy for icepick scar)
Fractional laser (POSTPONDED IN CASE OF ICEPICK) GF or PRP
FOR 3-6 SESIONS SECOND STEP OF TREATMENT double or triple SCREW THREADS it can be in 2 session 3 months in between
THIRD STEP OF TREATMENT FILLER BIOSTIMULATOR

Results: Based on my personal experience of various clinical scenarios in a busy laser practice that treats a significant number of patients with acne scarring, combined treatment is an excellent choice for treating all forms of skin scars with excellent results than single treatment. In additional, it speed the time to clinical improvement appreciated by the patient. Here we present personal experiences of combination treatments for acne scarring, pigmentation and textural issues, and suggested to be considered as a "gold standard" treatment of acne scarring in most of patient depending on skin type

Conclusion: Patient evaluation and expectations should be done and discussed prior to the initiation of any treatment. Treatment combinations are typically the best option for patients. The recent development of non-ablative lasers, radiofrequency devices, and different uses of fillers and toxins amongst others have broadened the scope with which we can treat scars.
My experience is the combined treatment is the best and moreover what the doctor starts 1st depending on his experience and knowledge of healing steps

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 Fiorella DERIU

Italy

Other author(s) : Dr. Roberto Amore

Fractional peeling

Objectives: Demonstrate the effectiveness and safety of combined technique of peeling and microneedling for different types of blemishes through a clinical study

Introduction: Fractional peeling, like fractional photothermolysis and resufacing with voltaic arc dermabrasion, shares the aim of increasing efficacy without extending recovery time: microneedling or percutaneous collagen induction induces controlled mechanical trauma, stimulating epidermis and dermis through tissue repair process, and creating microchannels capable of making preparations applied to the skin go beyond the cornea barrier, increasing their absorption; the soft peeling exerts a chemical effect capable of breaking the intercellular bonds and causing desquamation, stimulating the inflammatory.

Materials / method: Multicentered uncontrolled clinical study with 56 patients with advanced signs of photo and chrono aging (Glogau 3-4) treated with Peppermint peel (PMP Medical Device - Marc Medical srl, Cecina, Italy) and micro needling combined.

Results: no significant differences in the different subpopulations compared: males–females, Glogau 3- 4, smokers–non smokers, phototypes 1–4, or subjects who had their check up at 30 days–control group who had their check up at 60 days. The wrinkles that benefited most from the treatment were cheek and periauricular wrinkles, and lines of the corners of the mouth.The treatment had an average recovery time of 6.3 days (±2.3) which involved, in chronological order: erythema, hypersensitivity and skin hyperreactivity in the first phase(2–3 days), then subsequent desquamation with transient discoloration

Conclusion: The limitation of this research was the lack of a control group treated with only a soft
peel or microneedling monotherapy. In conclusion, the outcomes of this study demonstrate
the therapeutic efficacy of the combined microneedling-peeling treatment on different
types of wrinkles and suggest that combined microneedling-peeling treatment constitutes
a good treatment with encouraging results and minor side-effects.

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 World Congress 2022 Program

FOCUS ON S011

Contributing lectures - Clinical dermatology & dermatologic surgery

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2022
Program