Skindaily e-Edition Saturday, June 13, 2015

Watch forpotential bias inclinical trialsby JoHN EVANS,for skindaily

VANCouVER—Intentional or notthere are a lot of potential sourcesof bias in clinical trials which canlead to inaccurate or misleadingresults, so clinicians should havea keen skill at critically appraising

papers that appear in the scientificliterature, says Dr. An-Wen Chan,speaking at the World Congress ofDermatology’s Global Celebra-tion Forum on dermatologic sur-gery on Wednesday, June 10.

“It is clear that clinical trialscan be biased at all stages fromtheir design all the way to the re-porting or non-reporting in publi-cations,” says Dr. Chan. "It isimportant that we familiar withcritical appraisal so that we can weed out fact from fiction. And

overall, it is very important whenyou pick up a journal article, toapproach it with a degree of cyni-cism.” He is Staff Consultant inDermatology & Mohs Surgery atWomen’s College Hospital inToronto, Canada, and AssociateProfessor, Division of Dermatol-ogy, Department of Medicine atthe University of Toronto.

READ BEYOND THE ABSTRACT

This may seem to be self-evident,says Dr. Chan, but all doctors areguilty of reading only a study’s ab-stract at one time or another. But itis important because abstractsleave out details such as study de-

Sat.June 13 2015

skindailypowered by skinchronicle

international

Assessing role of theskin microbiome in ADInterplay between pathogens,commensal bacteria understudy, says Dr. Thomas Bieber

Controversy on treat-ment economics: Innova-tive, expensive treatments for afew, vs. low-cost medicationfor all? Attend the debatetoday, 14:00 hours in West223-224.

Five favorite views ofVancouver: Dr. KatieBeleznay, a dermatologist inthe city, offers her five choices.Send us yours (photos, too) toderm.city

InternationalFoundation forDermatology IFD vice-chair Claire Fuller describesthe group’s work to improvedermatologic care in resour-cpoor jurisdictions.

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Day recognizeschallenges of peo-ple with alibinism VANCouVER—The ILDS willmark the first annual InternationalAlibinism Awareness Day today.Initiated by the UN in Nov. 2014,the day is designed to heightenawareness of the condition and theviolence, stigmatization, low vi-sion, and high risk of skin cancerfaced by these people.

derm.city

www.

Info onthe go

Get hourly WorldCongress news

updates via Twit-ter, plus daily pod-

casts, images and video re-ports sent directly to yourmobile device. Only atwww.derm.city“Where Dermatology lives”

Todayat the World

Congressby DR. CHARLES LYNDEEDITOR of skindaily

Final attendance numbersfor the Vancouver WorldCongress have not yet beenreleased, but the projectedattendance of 11,000 derma-tologists from across theglobe has, in my humble es-timation, been surpassed.

As I have ventured fromscientific session to sponsoredsymposia to the wide-rangingCanadian Dermatology Asso-ciation’s Global Celebrationforums (and not to forget theexhibit hall), I have beengreeted with enthusiasm andprofessional comaraderie.Please take a moment to tell ushow we did at SkinDAILYthrough derm.city,where you cansign up for fu-ture informa-tion, and keepin touch.

WCD 2015: First International AlbinismAwareness Day recognized at conference

1City Maps 2Go by Ulmon GmbH is a travel guide and of-fline map. It is not a replacement for City Guides by Trip Advisorbut it is the best app that DOES NOT use data while travelingabroad since it only uses GPS. http://tinyurl.com/neecfpn.

2Genius Scan-PDF scanner by The Grizzly Labs. Thisscanner in your pocket that allows exportation as JPEG or multipage pdf in b&w or color. It uses smart page detection, perspec-tive correction and image en- continued on page 12continued on page 4

My 5 favoriteapps

contributed byDr. Ronald Vender,Hamilton, Canada

OFFICIAL NEWSPAPER OF THE 2323RDRD WWORLDORLD CCONGRESSONGRESS OFOF DDERMATOLOGYERMATOLOGY

ASSESSMENT OF STUDIES: Six keypoints for critical appraisal of literature

E-mail: [email protected]: @dermcity

Dr. Chan

The ILDS will recognize the first International Albinism Awareness Day on Saturday, June 13,the closing day of the WCD. At a news conference Friday, speakers outlined the challengesfaced by people with albinism. Pictured from left are: Dr. Margot Whitfeld, Australia, Dr.Jerry Shapiro, President, 23rd World Congress, Prof. Roderick Hay, Chair, International Foun-dation for Dermatology, Paul Ash of Under the Same Sun Canada, Dr. Claire Fuller, Vice-chair, IFD, and Dr. Harvey Lui, Secretary-General of the 23rd World Congress.

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Photos and images from the WCD Why not share yours with your colleagues?

Visit www.derm.city, “Where dermatology lives” derm.city

www.

Effective futuretreatments maydepend on thisresearchby JoHN EVANSfor skindaily

VA N C o u V E R—The interplaybetween pathogens and commen-sal bacteria that collectively makeup the human microbiome istremendously complex, but under-standing it may hold the key to fu-ture treatments for atopicdermatitis (AD), says Dr. ThomasBieber, director of the departmentof dermatology and allergy at Uni-versitäts Klinikum Bonn in Bonn,Germany.

“I compare the skin micro-biome to what we call in French aménage à trois,” said Dr. Bieber,speaking at the atopic dermatitis

symposium at the WDC on Tues-day, June 9. “It’s a kind of mutu-alism between the commensalsand the pathogens, and our ownskin cells. This happens throughdifferent kinds of receptors, in-cluding the Toll-like receptors.This kind of cross-talk, this mé-nage à trois, seems to be very ef-ficient at balancing thecomposition of our microbiome.”

“Everything is regulatedthrough the production of so-called anti-microbial peptideswhich are produced not only bythe keratinocytes themselves, butalso from other microbes whichare on the skin which are also pro-ducing antimicrobial peptides tocontrol the growth of potentiallypathogenic microbes on our skin,”he said.

This initial interplay only di-rectly engages with the innate im-mune system, said Dr. Bieber. The

dendritic cells then provide a com-munications bridge between thisdialogue between bacteria and theinnate immune system and the re-active immune system, sensingmicrobial activity through the toll-like receptors and then instructingthe proper reaction of the reactiveimmune system through the T-

helper-17 cell response. This re-sponse in turn can upregulate theproduction of antimicrobial pep-tides in the skin.

There is evidence from soon-to-be-published research suggest-ing the dendritic cells of patientswith AD have a defective sensingresponse to Staphylococcus-de-

rived products, said Dr. Bieber.“From this lack of response

the cells are not able to induce thedefault TH-cell mediated re-sponse, and in fact they are notable to turn on the antimicrobialpeptide production in the skin,” headded. “In other words we have

ASSESSING THE ROLE OF THE SKIN MICROBIOME IN AD: Interplay between pathogens, commensal bacteria under study

Do you know of a patient with Sjögren-Larsson Syndrome?Sjögren-Larsson Syndrome (SLS) is a rare genetic disease that affects approximately one in250,000 individuals and is characterized by congenital ichthyosis (scaly, thickened, dry skin),neurologic deficits (which may include spasticity, seizures, and cognitive delay), and in somepatients, retinal dysfunction. These symptoms are apparent by early childhood.

SLS is caused by mutations in the ALDH3A2 gene, which encodes an enzyme called fattyaldehyde dehydrogenase (FALDH). FALDH converts long chain aldehydes into fatty acids. InSLS patients, FALDH activity is significantly reduced or absent, resulting in an accumulation oftoxic fatty aldehydes and associated derivatives that lead to the clinical manifestations of thedisease. There are no FDA-approved therapies for SLS at this time.

Currently, awareness of SLS is low, and many SLS patients may be misdiagnosed. A topical therapy is currently being developed by Aldeyra Therapeutics to facilitate removal

of excess fatty aldehydes in patients with SLS and to treat their ichthyosis. The drug is investi-gational and has not been approved for sale in the U.S. or elsewhere. Details of the study canbe found on Clinicaltrials.gov at the following link:https://clinicaltrials.gov/ct2/show/NCT02402309?term=Sjogren-Larsson+Syndrome%3A&rank=2.

If you are aware of a patient with ichthyosis and neurological compromise(with or without retinal pathology), or if you have any questions about the currentclinical trial please contact Phil Piscitelli at [email protected] or (781) 761-4904 ext. 208.

Additional resources for SLSS• The Sjögren-Larsson Syndrome Registry https://slsregistry.rarelaunch.org/• The SLS Registry creates a platform for patients around the world to share information about

SLS with each other and with researchers on developmental history, medical complicationsand quality of life. The information is anonymous and may be shared with individuals or in-stitutions helping researchers and medical experts to gain a broader understanding of thedisease in order to improve diagnosis, advance research, and develop treatments.

• SLS Network Community https://www.facebook.com/SjogrenLarssonSyndromeDedicated to improving the lives of patients with SLS by providing support, awareness, andadvocacy to increase awareness of SLS.

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Roger Ho, USAThe true relation betweenvitamin D and the risk forpsoriasis is unclear. Thereneed to be a lot morestudies to substantiatethat fact, but I think itdoesn't hurt to recom-mend patients to take adaily supplement of Vita-min D. Most importantly,though, it is important tostress to patients that theydo not get their Vitamin Dfrom the sun.

4 • Saturday, June 13, 2015 skindaily • www.derm.city


skindaily Featured e-poster presentations: Be sure to investigate the first sessionof featured e-poster presentations, which begins Tuesday, June 9, 9:00 am to 1:00 pm.The International Poster Gallery is located in the Exhibit Hall

skindailyVol. 1 No. 4 June 13, 2015

www.derm.cityOfficial Newspaper of the23rd World Congress of Dermatology

Charles W. Lynde, MD, FRCPC

EDIToR, skindaily

Mitchell Shannon PuBLISHER

R. Allan RyanEDIToRIAL DIRECToR

Lynn BradshawSENIoR ASSoCIATE EDIToR

John Evans

Emily InnesASSISTANT EDIToRS

Sandi Leckie, RN

SALES & MARKETING

Cathy DusomePRoDuCTIoN & CIRCuLATIoN

Rose ArcieroCoMPTRoLLER

Published for the World Congress of Dermatology by Chronicle Companies, with offices at

555 Burnham thorpe Road, Ste306, Toronto, ont. M9C 2Y3Canada, and

Chronicle LifeSci America Corporation, Buffalo, NY14203 uSA

Telephone: 866-63-CHRoN(24766), 416-916-2476; Facs.416-352-6199

E-mail: [email protected]

Contents © Chronicle Infor-mation Resources Ltd., 2015except where noted. All rightsreserved worldwide.

The Publisher prohibits repro-duction in any form, includingprint, broadcast, and elec-tronic, without written per-missions. Printed in Canada.

Ideas in the Service of Medicinesm

Wayne P. Gulliver, MD, FRCPC

EDIToR,

skinchronicle international

Affiliated journals of the Chronicle Companies include skinchronicle (The Chronicleof Skin & Allergy), The Chroni-cle of Cosmetic Medicine +Surgery, The Chronicle ofNeurology & Psychiatry, Pedi-atric Chronicle, The Chronicleof Healthcare Marketing, andLinacre’s Books/Les EditionsLinacre

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4FlightBoard-Live Flight Departure and ArrivalStatus. FlightBoard gives you the airline name, destination,

gate number and time of arrival/departure. It’s just like an airportboard at a big airport. The app shows every flight arriving anddeparting the airport, but you can narrow it to just one airlinewith the search box. A valuable app when you miss a flight.http://tinyurl.com/porfb6z

5Currency Converter by OANDA Corp. Convertamounts for over 190 currencies and four metals. Keep fre-quently used currencies on quick access, and use a big-buttonkeypad to quickly enter conversion amounts. You can specify In-terbank rates, or use a percentage add-on to better predict the ac-tual rate charged by your bank or credit card company—you willsee both bid and ask rates. http://tinyurl.com/nbau7zr

MY 5 FAVORITE APPScontinued from page 1

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Exhibit Hall

Exhibit Hall

International Poster Gallery

AND HERE I AM...

David Buckley, IrelandThere are lots of [sights Ienjoy], I suppose the[nice] weather makeseverything look attractive,but the mountains and thesea are particularly attrac-tive now. Where I am fromin Ireland we have lots ofmountains and seas aswell, [and] it makes mefeel at home, so I wouldsay it is this situation thatmakes it special.

Watch for SkinDaily’s roving reporters to have an op-portunity to tell your story to your fellow dermatolo-gists. We welcome commentary of all kinds about theWorld Congress of Dermatology and your visit to Van-couver, so tweet SkinDAILY @dermcity.

Is there a clinical tip thatyou would like to sharewith SkinDAILY?

What has been yourfavorite attraction inVancouver?

Dr. Charles W. Lynde, Editor of SkinDAILY, discusses con-tent with Senior Associate Editor Lynn Bradshaw in theSkinDAILY offices at the Vancouver Convention Centre,East Building. Dr. Lynde invites your comments onSkinDAILY and the World Congress of Dermatology.

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ILDS will continuehumanitarian agenda,including Africantraining centre, globalscabies initiativeby JoHN EVANSfor skindaily

VA N C o u V E R—During the first meetingof the new Board of Directors of the Inter-national League of Dermatological Societies(ILDS) at the 2015 World Congress of Der-matology in Vancouver, Dr. Harvey Lui—president-elect of the League since Februaryof this year—will be formally ratified aspresident of the organization.

Dr. Lui is professor and head of the De-partment of Dermatology & Skin Science atthe University of British Columbia. He hasserved as a visiting professor in dermatol-ogy schools around the world, and has beenan editor and reviewer for several interna-tional dermatology journals.

“I am very humbled to be given the re-sponsibility to do this. I have a deep sense ofpride as a Canadian to be given the privilegeof leading this organization,” Dr. Lui says ofbeing elected to lead the ILDS. Canadianssometimes doubt their ability to make an im-pact on the world stage, he says, but Canadianphysicians and researchers have madetremendous contributions to dermatologic sci-ence.

“So I feel that, personally, this is my re-sponsibility and my opportunity to giveback to a specialty and a community inCanada and at the global level that has reallyhelped me to do the things that I thoughtwere important in dermatology,” says Dr.Lui. He adds that his achievements wouldnot have been possible without the supportof dermatologic societies both domestic andinternational, and the receptiveness of theinternational dermatology community hasbeen to ideas from around the world.

The ILDS is an international organiza-tion which has other dermatologic societiesas its members, and currently has approxi-mately 157 member organizations. “Thepresident’s role is to help lead the ILDS andco-ordinate the activities of the ILDS over afour-year term,” says Dr. Lui. These activitiesinclude stimulating co-operation betweendermatology societies around the world, en-couraging the advancement of dermatologyat the global level in education, patient care,and science, and providing a forum for thesharing of information about dermatology onan international scale, he says. “We want topromote professional relationships betweendermatologists and other health care

providers in the field of skin health.”As well, the ILDS represents dermatol-

ogy at the level of international commis-sions and health organizations, includingbeing the only organization devoted to der-matology in the world that has an officialrelationship with WHO, the World HealthOrganization, says Dr. Lui.

PLANS TO FOSTER ENGAGEMENTDuring his four-year term as president, Dr.Lui says he hopes to foster engagement be-tween physicians and the ILDS on an on-going basis, expanding on the activity thatpeaks with the World Congress of Derma-tology every four years.

“An individual dermatologist doesn’tjoin as a member of the ILDS,” says Dr.Lui. “But that doesn’t mean that an individ-ual can’t have a relationship with the ILDSand understand what its goals and objec-tives are, and contribute to it. The analogyI use is that it is like the World Health Or-ganization (WHO). Countries are membersof the WHO, not individual citizens. How-ever, citizens of the world recognize whatthe WHO is, they contribute to it, they areaware of it, and it is a very vital organiza-tion in the world. That’s the same kind ofthing I want to achieve for ILDS. To getpeople to really understand that betweenthese World Congresses, there is a lot of ac-tivity happening at the international levelby a number of different organizations—es-pecially just the ILDS.”

Among the key directions Dr. Luihopes to emphasize at the ILDS during histerm as president is to address the disparityof dermatologic care in the world. Whilethe leading edge of research is unlockingnew and better treatments all the time, hesays “we have countries and places in theworld that can’t even access simple, basicdermatologic care. So in addition to helpingunderstand and communicate about all thegreat advances, we have to figure out howto deal with the disparities in the world.[There is a] growing gap between the peo-

ple who can get access to the very bestquality care and some people who can’teven get access to basic standard treatmentfor skin infections.” Conditions such as sca-bies, which is considered a nuisance para-sitic infection in the developed world, is amajor cause of suffering and economic bur-den elsewhere, he noted.

The ILDS will also continue to cham-pion humanitarian causes, such as the Re-

gional Dermatology Training Centre in Tan-zania, the International Alliance for the Con-trol of Scabies, and support for persons withalbinism, through the International Founda-tion for Dermatology (IFD), says Dr. Lui.The IFD was established to improve themanagement of skin disease in underservedareas of the world and is hosting a numberof sessions and displays throughout theWorld Congress in Vancouver.


skindaily What’s Hot in Cosmetic Dermatology? Kyle Koo-Il Seo, MD,PhD of the Department of Dermatology, Seoul National University Hospital (SouthKorea) presents this morning at 10:30 a.m.

DR. HARVEY LUI NEW ILDS PRESIDENT: ‘Wewant to promote professional relationships in skin health’


Dr. Lui

WHO’S WHO AMONG THEINTERNATIONAL SOCIETIESEUROPEAN SOCIETY FORDERMATOLOGY AND PSYCHIATRYThe European Society for Dermatology and Psychiatry (ESDaP) is a sci-entific society with more than 100 members from around the world, saysItalian dermatologist Dr. Michael Dennis Linder, president of the society.The ESDaP was originally established in 1993 in Vienna, Austria.

The ESDaP provides a forum for European physicians and psychol-ogists working in psychodermatology, psychosomatic dermatology,and dermato psych iatry, with an aim to foster exchange of informationand ideas. As well, the society tries to encourage contacts among pro-fessionals in the field to improve the quality of scientific research inthose three areas, and to recruit new members in order to provide im-portant expertise. More info at http://www.psychodermatology.net

THE COSMETIC DERMATOLOGYSOCIETY OF INDIAThe Cosmetic Dermatology Society of India (CDSI) was established 18years ago with 50 members, but now has a strength of more than2,000 members, says Dr. Rekha Sheth, CDSI founder and president.CDSI was formed to teach scientific aspects of Cosmetic Dermatol-ogy, to impart scientific knowledge on the techniques and proce-dures in cosmetic dermatology, to educate both medical practitionersand the general public, and to “discourage quackery,” says Dr. Sheth.

Medical education in India does not include cosmetic dermatology,says Dr. Sheth. “our [annual] conferences and workshops fill in this gapencouraging safer standards in patient care while imparting knowl-edge, education, and learning in a scientific manner.” More informationon CDSI is available at the group’s webpage at www.cosdermindia.in.

CANADIAN DERMATOLOGY FOUNDATIONThe Canadian Dermatology Foundation (CDF) announced Dr. DenisSasseville of Montreal is the honored recipient of the 2015 Practitionerof the Year Award. “Throughout his distinguished career Dr. Sassevillehas greatly enriched the field of dermatology through patient care,teaching, research, and leadership,” said Dr. Neil Shear, CDF president.

Dr. Sasseville is world-renowned for his expertise in contact der-matitis, and he has been a very active member of both the NorthAmerican and European Societies. He has directed the McGill univer-sity Patch Test Clinic since 1989, where he receives referrals for com-plex contact dermatitis cases from throughout Quebec and easternCanada. Dr. Sasseville also runs a demanding general dermatologyclinic at the Royal Victoria Hospital in Montreal, where he teachesmedical students and residents.

Dr. Sasseville has always had a great passion for dermatologic re-search. Throughout his career he has published more than 20 bookchapters and over 120 peer-reviewed publications in high-profile inter-national journals. He is recognized as a world-class researcher in thefields of Contact Dermatitis and Cutaneous T-Cell Lymphoma (CTCL).

Dermtek ad_Layout 1 6/13/2015 11:24 AM Page 1

Featured e-poster presentations are underway in the International Poster Gallery in

the Exhibit Hall. Comment now at www.derm.city,“Where dermatology lives”

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by skindaily STAFF

VA N C o u V E R—The final ofthe 23rd World Congress ofDermatology’s debate-styleControversies sessions kicks offat 2 P.M. Saturday with a face-off about where resourcesshould be directed regardingdermatologic pharmaceuticalsfrom now until the year 2025.The two sides will be arguingeither that the resource directionshould focus on continuing to

invest heavily into innovativenew therapies, or if providingdecent quality, inexpensive careto the largest number of people

is better.Arguing in favor of wide-

spread, low-cost medication willbe the team of Dr. Warren Piette,a dermatologist and professor atthe Rush University MedicalCenter inCh icago ,I l l i n o i s ,and Dr.Joerg Alb -r e c h t ,chair ofthe Sys -t em w i d eDrug andFormularyCommi t -tee and at-

tending dermatologistin the Division ofDermatology, Depart-ment of Medicine atthe J.H. Stroger Hos-pital of Cook County,

Illinois.

BROADER USE OF GENERICSTHE ANSWER?Dr. Albrecht maintains that

generic formulations have thebiggest impact on patient health.“Of the 103 drugs that we use indermatology at Cook CountyHospital, five are branded drugsprior to patent expiration (azelaicacid, levulan sticks, pime-crolimus, and etanercept), andazelaic acid is already a genericin Britain. We are doing well withthis formulary for the over-whelming majority of patients,and these drugs are affordable.”Further, the full benefits of thesedrugs has yet to be unlocked, hesays.

Other points Dr. Albrechtand Dr. Piette will be addressinginclude how drug costs can im-pact nations at different levels ofdevelopment in a variety of ways,as well as the morbidity associ-ated with lack of access to med-ication.

When: Saturday, June13, 2015, 2 p.m.

Where: West 223–224Global Dermatology in2025—Innovative Ex-pensive Treatmentsfor a Few VersusLow-cost Medica-tions for Everyone?

Controversyin treatmenteconomics

Dr. Albrecht Dr. Piette

8 •Saturday, June 13, 2015 skindaily • www.derm.city


skindaily Skin Cancers and Viruses: Lessons from Kaposi’s sarcoma and Merkel cellcarcinoma, from Distinguished Lecturer Patrick Moore, MD, MPH, Department of Molecular Mi-crobiology and Genetics, University of Pittsburgh, Cancer Virology Program, Hillman Compre-hensive Cancer Institute, tomorrow (Saturday, June 13) at 10:30 a.m.

IFD vice-chair Claire Fullerdescribes work of group toimprove dermatology care inresource-poor jurisdictions

VANCouVER—One of the founding principles of the In-ternational League for Dermatological Societies (ILDS),which is celebrating 80 years of existence, is to “encouragethe worldwide advancement of dermatological education,

care, and sciences.” The creation of the Inter-national Foundation for Dermatology (IFD)has been essential in accomplishing thisrole. DR. CLAIRE FULLER, the vice chairof IFD and a consultant dermatologist forChelsea and Westminster Hospital inLondon, corresponded with SkinDAILY’s

Emily Innes about the role and the significance of the IFD.

WHY WAS THE INTERNATIONAL FOUNDATION FORDERMATOLOGY CREATED?The IFD was created in 1987 as an arm of the InternationalLeague for Dermatological Scieties to focus on improvingdermatological care in resource-poor areas of the world.

It was formed following the first pan-African Derma-tology Congress held in Arusha, Tanzania in 1981. [Thecongress] concluded that a series of regional dermatologytraining centres should be established in East, West andCentral Africa to address the massive dermatology skilldeficit across the continent. This was the first and signatureproject of the IFD, to establish the first Regional Derma-tology Training Centre (RDTC) in Moshi, Tanzania.

WHAT HAVE BEEN SOME OF THE MAJOR PROJECTS

ORGANIZED THROUGH THE IFD?The RegionalDermatologyTraining Cen-tre in Moshi[pictured left]has now train -ed over 250

dermatology officers who are now working in 15 Africancountries delivering dermatology care to their patients. Ad-ditionally it has graduated 19 dermatology specialists froma residency program. A similar unit is now established inCambodia.

The Comprehensive Care Program for Persons WithAlbinism is a community-based outreach program [in Tan-zania] to support people with albinism in the tropical set-tings to have access to sun protection, skin cancerprevention, skin cancer treatment, and also eye care.

Community Dermatology Training Programs in Mex-ico and Patagonia are short one to two day teaching pro-grams for local health care workers followed bycommunity clinics carried out in remote rural locations inresource-poor areas.

The International Alliance for the Control of Scabieshas been instrumental in establishing this global network

of multidisciplinary experts in co-ordinating the effort tocontrol scabies. It has achieved this by being involved inadvocacy: raising awareness among international healthministries, ensuring the understanding of the significant im-pact scabies can have on leading to serious long term healthsequelae such as renal and heart disease, and leading thedevelopment of research tools and priorities.

IFD advises the WHO on dermatological issues such askey essential drug availability and how to recognize the seri-ous tropical diseases classified as neglected, that lead to largeglobal health burdens, especially in resource-poor tropicalsettings. Many of these [disease] have skin manifestations.

HAVE YOU BEEN INVOLVED IN SOME OF THEINTERNATIONAL PROJECTS AND, IF SO, WHAT WAS THEEXPERIENCE LIKE?I have been involved in most of these initiatives. I was asenior lecturer on the staff at the RDTC for a year in Moshi.It was an unforgettable and challenging experience of de-livering a dermatology clinical and educational service inan environment with very limited resources. Although I didsee some exotic diseases, it was more the challenge ofworking with limited facilities and with very poor and verysick patients that will stay with me.

Mixing with the WHO and global health communityhas been a fascinating experience. Many have neverworked with dermatologists before and it has been excitingto open their eyes to what we can bring to the table.

WHY DO YOU THINK THIS IS AN

IMPORTANT FOUNDATION?The aim of IFD is to attempt to co-ordinate the efforts ofdermatological health interventions in resource-poor set-tings. Additionally IFD attempts to develop a strategic planon how to raise the profile of a consideration of skin carein the global health and developing country medicine arena,

and to ensure that dermatologists have an influence in shap-ing health care provision among these neglected diseasesand communities. We know we can make a big differencesometimes with very simple interventions.

WHAT ARE SOME CONCERNS WHEN SKIN CONDITIONS

GO UNTREATED IN DEVELOPING COUNTRIES?A good example of this would be uncontrolled scabies.When this runs through communities affecting especiallythe young, old, and frail in epidemic proportions, the itch-ing and scratching leads to secondary bacterial infection ofthe skin. This impetigo can then lead to septicemia andglomerulonephritis and even rheumatic heart disease andleave patients with long term renal and heart valve damage.Scabies is probably the most common cause of renal failurein the world, and yet this is not a well known fact. If it was,there would be much more attention directed at mass drugadministration projects to treat whole communities andclear scabies epidemics in places like Fiji and other WesternPacific islands.

Another example would be failing to protect personswith albinism from the sun, which leads to them gettingskin cancer at a very young age. Very few persons with al-binism in Tanzania survive beyond 30 to 40 years of agedue to the development of skin cancer.

WHEN WAS THE COMMUNITY DERMATOLOGY JOURNAL

STARTED AND WHAT TYPE OF IMPORTANT ARTICLES

DOES IT RUN?It was launched in 2004 and now on its 18th edition. Theaim of the journal is to bring up to date, relevant informationon the diagnosis and treatment of skin disease to healthworkers in rural areas, using the resources available to them.It also set out to provide information that could be used toeducate health workers and the populations they serve.

More information can be found at http://www.ifd.org/

INTERNATIONAL FOUNDATION FOR DERMATOLOGYMaking a big difference with ‘simple interventions’

Featured e-poster presentations are un-derway in the International Poster Gallery in

the Exhibit Hall. Comment now at www.derm.city,“Where dermatology lives”

derm.city

www.

skindaily • www.derm.city Saturday, June 13, 2015 • 9

THE FRENCH SOCIETYOF DERMATOLOGYThe goal of the long-standing French Societyof Dermatology is to encourage research,teaching, and the development of guidelines,says the societies president and France-based dermatologist Dr. olivier Chosidow.

“We have a lot of working groups belong-ing to the French Society of Dermatology de-voted to clinical research aiming to supportclinical trials, epidemiological studies, and infact we are publishing a lot of studies on[our] behalf,” says Dr. Chosidow.

This society has more than 2,400 mem-bers from both private practices and the hos-pital, with a current administrative council of21 positions. More information at www.sfder-mato.com.

THE WOMEN’SDERMATOLOGY SOCIETYIn 1973 Dr. Wilma Bergfeld, a Cleveland-baseddermatologist and the first female presidentof the American Academy of Dermatology,recognized a lack of women dermatologists inleadership positions and so she founded TheWomen’s Dermatology Society (WDS).

“The mission of the Women’s DermatologySociety is number one to promote leadershipand also to develop friendships and relation-ships through mentoring and networking,”says Washington-based dermatologist Dr. Va-lerie D. Callender, president of the WDS.

Though the group had humble begin-nings, the WDS now has 1,500 national (inAmerica) and international members. TheWDS has a sister society in Europe, India, andone is being started in South Africa. Thegroup is primarily (about 90%) women, butthere are also male dermatologist members,says Dr. Callender. The WDS is actively seek-ing to increase the number of male members.

For more about the WDS visit www.wom-ensderm.org.

WHO’S WHOAMONG THEINTERNATIONAL SOCIETIES


skindaily Using the Skin to Influence Systemic Immunity: Presen-tation by Jan Dutz, MD, FRCPC, epartment of Dermatology and Skin Science, University ofBritish Columbia, tomorrow (Saturday, June 13), 10:30 a.m.


3Gen/DermLite ........................................1701A

A.R.C. Laser GmbH ................................1837Abbvie ........................................................711Adoderm GmbH ......................................2003Revivogen ................................................2143Allergan ......................................................743Alma Lasers ............................................2109American Academy of Dermatology ........1939American Society for Dermatologic Surgery ......................................................................1112Amgen........................................................421AQ Skin Solutions ....................................1609Asclepion Laser Technology GmbH ........1540

BBangalore Bids for WCD 2019 ................1846Bayer Consumer Care ..............................937Beiersdorf ..................................................431Benev ........................................................517Bios S.R.L. ..............................................1801Bloomage Biotech ....................................1441Brymill Cryogenic Systems ......................1800Btl Aesthetics ........................................1619C

CCaliber Imaging & Diagnostics, Inc. ........2129Canadian Dermatology Association ........1945Canfield Imaging Systems........................1137Capiderma Canada & Puriaderm Canada ......................................................................1636Caregen Co., Ltd. ....................................2023Celgene....................................................1401CeLuvia & INCI Medica..............................547

Chemotechnique Diagnostics/Dormer Labora-tories ..........................................................619Chiltern International Inc. ........................1146Chinese Society of Dermatology ..............2119Chromogenex Technologies LTD ............1716Chungwoo................................................1339Cipher Pharmaceuticals Inc. ....................1044Clarisonic ................................................918CClassys ....................................................2100Clinical Resolution Laboratory Inc. ..........2001Clinique ......................................................623CoLabs Intl. Corp ....................................1438Colegio Ibero Latinoamericano de Derma-tología (CILAD) ........................................2044Conmed....................................................1039coolsense medical....................................1015Cortex Technology ..................................2137CosMedical Technologies®......................1343Cosmofrance ............................................1110Courage+Khazaka electronic GmbH ......1012CRC Press................................................1115Cynosure..................................................1509

Ddaavlin......................................................1903Daeju Meditech Engineering (Infilux) ........409DANA ......................................................1151deka ........................................................1243Delasco ....................................................1436Dermaceutic ..............................................712Derm.City “Where Dermatology Lives” ....2139Dermaroller GmbH ..................................2142Dongbang Medicare ................................1839

DOSIS M&M Co., Ltd. ..............................1210DTS MG ..................................................1037Dubai Department of Tourism and CommerceMarketing - GCC League of Dermatologists ....................................................................1251Dynamify GmbH ......................................1543

EEli Lilly and Company ..............................1001Ellipse A/S ................................................1142Ellis Instruments, Inc. ..............................1617Elsevier ......................................................400EndyMed Medical ......................................637epgonline.org ..........................................2147Dermapenworld - Equipmed ....................1409Eufoton Medicalasers ..............................1045European Academy of Dermatology andVenereology ............................................2038

FFibroTx LLC ............................................1938FineMEC ....................................................411Focus Medical ..........................................1750FotoFinder Systems GmbH......................1527Fotona ........................................................843

GGalderma ..................................................916General Project ..........................................617GMC Medical ............................................737Agnes ........................................................404Czech Academy of Dermatovenereology 1150

HHansBiomed Corp ....................................1147Health Match BC........................................301

Technical exhibitsHoursTuesday, June 9 09:00 – 17:00Wednesday, June 10 09:00 – 17:00Thursday, June 11 09:00 – 17:00Friday, June 12 09:00 – 17:00Selected consulates:Consulate of Ireland in Vancouver, 837 Beatty Street, Suite

210, (604) 683–9233. http://www3.bc.sympatico.ca/Irish-Consul/ Distance: a six-minute drive.

Consulate General of The united States in Vancouver, 1095West Pender Street, Suite 2100, (604) 685–4311, http://van-couver.usconsulate.gov/ Distance: a five-minute walk.

Consulate General of India in Vancouver, #201–325 HoweStreet, (604) 662–8811. Distance: a six-minute walk.

Consulate General of France, 1100—1130 West Pender Street,(604) 637–5300. Distance: a six-minute walk.

Consulate General of People of Republic of China, 3380Granville Street, (604) 734–0704. http://vancouver.china-consulate.org/ Distance: a 30-minute drive.

Consulate General of Japan, 1177 West Hastings Street, #900,(604) 684–5868,

http://www.vancouver.ca.emb-japan.go.jp/ Distance: a six-minute walk.


Tweeting live from the WCD Exhibit HallKeep ahead of the technology and newest discoveries


www.

Where do I find...?Closest post office, WaterfrontCentre at 200 Burrard Street (insidethe Carlton Cards shop), 604–681–8699. Distance: a two-minute walk.Closest beauty salon: Kaori HairDesign, Waterfront Centre at 200Burrard Street, http://www.kaori-hair.com/ or email [email protected]. Distance: atwo-minute walk.Closest barber shop: MarineHairstyling for Men, 355 BurrardStreet, (604) 688–9214. Distance: athree-minute walk.Closest dentist: Oceanfront Den-tal Group, Waterfront Centre at 200Burrard Street, 604–408–1061. Dis-tance: a two-minute walk.Closest tailor: Waterfront DesignerTailor, Waterfront Centre at 200 Bur-rard Street, 604–806–3990. Distance:a two-minute walk, or a stitch in time.Closest shopping centre: PacificCentre, 701 West Georgia Street,www.pacificcentre.ca, (604) 688–7235. Distance: a 10-minute walk.Closest dry cleaners: Dressed inBlue Dry Cleaners, 355 BurrardStreet, www.dressedinblue.com,(604) 683–2583. Distance: a five-minute walk.Closest shoe repair: WaterfrontShoe Repair, Waterfront Centre at200 Burrard Street, 604–683–2866.Distance: a two-minute walk (fouron a broken heel).Closest currency exchange:Vancouver Bullion & Currency Ex-change, 800 West Pender Street,(604) 685–1008. Distance: a five-minute walk.Closest coffee: Starbucks, 200Burrard Street (604) 605–3144. Dis-tance: a one-minute walk.Tim Hortons, 200 Burrard Street,(604) 692–0348. Distance: a one-minute walk, or 45 seconds ifyou’re full of caffeine.Closest hospital: St. Paul’s Hos-pital, 1081 Burrard Street, (604) 682–2344. Distance: a 20-minute walk.Closest medical clinics: SteinMedical Clinic, 550 Burrard Street,(604) 688–5924. Distance: a five-minute walk.Ultima Medicentre, 1055 DunsmuirStreet, (604) 683–8138. Distance: aseven-minute walk.Closest pharmacy: Rexall, 1055W Georgia St., #122 Royal Centre,(604) 684–8204. Distance: a 12-minute walk.Closest supermarket: Urban FareCole Harbour, 305 Bute Street, (604)669–5831, email:[email protected]. Open 7 A.M. to 10P.M. Distance: a six-minute walk.Closest liquor store: BC LiquorStores Harbour Centre, 555 WestHastings, (604) 660–4574. Open 10A.M. to 6 P.M. Monday to Saturday.Closed Sunday. Distance: a nine-minute walk.

Hoffmann-La Roche ................................1709Holistic Brands Corporation ....................1537Hyacorp....................................................1900HydraFacial MD - Edge Systems ..............851Hyundae Meditech Co., Ltd. ....................1047

IIDPOC - Expanding Horizons for DermatologyPatients ....................................................1947Creative Ilooda ..........................................313Industra ....................................................1904Infinite Trading Inc. ....................................646Infuez........................................................1152InMode ....................................................2002Innovaderm Research Inc. ......................1145Innovapharma ..........................................1237Wcd 2019 Rio De Janeiro ........................1747International Classification of Skin Diseases(ICD-11)....................................................2144International Foundation for Dermatology2043International Hair Restoration Platform ......445International Psoriasis Council ................1642International Society of Dermatology ......2040Isis Pharma ..............................................1431

JJapan Bio Products Co., Ltd.......................611Jeisys Medical Inc. ....................................417JenLab......................................................1011Jilin Province King Laser Technology Co.,Ltd...................................................................508Johnson & Johnson..................................1717June by netatmo ......................................1940

KKai industries Co.,Ltd. ..............................2127Karger Publishers ......................................545Kernel Medical Equipment Co. Ltd.............837Kunming Beitaini Biotechnology Co. Ltd ....401Kythera Biopharmaceuticals ....................1720

LLa Roche-Posay ......................................918eLaboratoire Bioderma ................................701Laboratoire Bioderma ................................702Laboratoires Dermatologiques D Uriage..1627Laboratoires Filorga ................................1637Larosh Dermocosmetic Laboratories ......2004LÒreal Paris by L’Oréal Paris ..................918ALumedtec..................................................1138Lumenis....................................................2101

MMcure Co.. Ltd. ........................................1052The mdBriefCase Group ..........................1252Medisca......................................................742Medisca......................................................643Merz ........................................................1209Mesoestetic SL ........................................1531MetaOptima Technology Inc.......................839Miramar Labs ............................................309Modernizing Medicine, Inc. ......................1529amiea med ..............................................1841

NNarimya Pharmaceuticals Inc ....................305NeoStrata Company, Inc. ........................1628N-Finders Co.,Ltd.....................................2000Northern Health..........................................303

NovaCutis ................................................2037Novartis Pharmaceutical ............................721

PPersonna Medical ....................................1937Pfizer Inc. ................................................1643Pierre Fabre Dermo-Cosmetique ............1201Pollogen Ltd. ............................................1427Procter & Gamble ......................................801Prollenium Medical Technologies Inc. ........911Prostemics ................................................510

QQuanta System spa....................................601QuantifiCare..............................................1111Quintessence Medical ..............................1144Q-SkinScience / Rejuvesse MD ..............1337

RRegeneron/Sanofi ....................................2017Restoration Robotics, Inc. ........................1901Rose Micro Solutions ..............................2133

SS&V Technologies GmbH ..........................845Sandoz Canada Inc. ..................................710Sction ........................................................913Turkish Society of Dermatology ..............1043Shanghai SIGMA High-tech Co.,Ltd ........2117Sharm Derm 2015....................................2046Shenzhen GSD Tech Co.,Ltd ..................1621Skin Health Alliance ..................................945SkinCeuticals ..........................................918BSkinCHRONICLE International ................2139SkinDAILY Newspaper ............................2139SmartPractice ..........................................2104

Stemcell Technologies, Inc.........................544Stiefel, A GSK Company ..........................1417Suneva Medical..........................................947Surgicube International B.V. ....................1651Syneron Candela ....................................1809

TTavTech Ltd. ............................................2121The JAMA Network ....................................402ThermiAesthetics ......................................944Tiemann Surgical ....................................1703Tilley Endurables......................................1442TiZO by fallene ..........................................645TKL Research ............................................749tpm taberna pro medicum GmbH ............1805

UUBC Skin Care Centre ............................2047Under The Same Sun (UTSS) ................2045Unilever PLC..............................................216

VVenus Concept ..........................................501Verisante Technology, Inc. ........................1114Vichy........................................................918DScarLet RF ................................................647Vivier Pharma ..........................................1013Viviscal ....................................................1638

WXYZWaldmann - Engineer of Light..................1752WCD 2019 Milan BID ..............................1014Wiley ........................................................2102Wolters Kluwer ..........................................644WON TECH..............................................1845Zimmer ......................................................609

sign which can reveal a lot of potential bias, and interpreta-tions and conclusions may not even follow the data.

For example, a study published in The Lancet Oncol-ogy which compared PDT vs. topical imiquimod vs. 5-FUfor superficial basal cell carcinoma had data that showedno significant difference in five year recurrence rates anda slight favoring of 5-FU in terms of serious adverse events.

“But if you look at the conclusion of the abstract, it

says on the basis of these findings, imiquimod can be con-sidered the preferred treatment,” says Dr. Chan. “Now,where that conclusion can ever be drawn is unclear. But ifyou were to rely only on the conclusion line, then youwould expect that you should be using imiquimod.”

ASSESS THE COMPARATORS IN THE TRIAL

“What you are comparing the new or novel treatment towill determine your outcomes,” says Dr. Chan. There were

two major studies comparing Moh’s micro-graphic surgery to standard surgical excisionfor superficial basal cell carcinoma, he says.One with Moh’s initial margin at 3 mm andstandard excision at 3 mm, the second with ini-tial margin at 2 mm and standard excision at 4mm. “Those of you who have done Moh’s orare very familiar with it know that we start witha smaller margin, first of all, than 3 mm. It iseither 1 mm or 2 mm. And standard excision isusually more than 3 mm. So if you’re going tostart [your study] by increasing the Moh’s mar-gin and reducing the initial surgical excisionmargin, then you’re going to get what you ex-pect with regards to whether Moh’s turns out tobe tissue-sparing with a smaller defect size.”Unsurprisingly, the 3 mm/3 mm study found nosignificant difference in final defect size be-tween the two techniques, while the more rea-sonable 2 mm/4 mm study published inDermatologic Surgery found there was a sig-nificant difference in final defect size.

HOW ARE PARTICIPANTS RANDOMIZED?Randomization of patients is the heart of what makes random-ized controlled trials the gold standard of evidence based med-icine, says Dr. Chan, but it is shockingly common that themethod of randomization is omitted from a study. Assessingquality of randomization involves two factors, Dr. Chan says:method of randomization and how well the randomization isconcealed from the individuals enrolling patients.

CHECK FOR PROPER BLINDING OF THE STUDY

“Ideally, everyone should be blinded” in a study, says Dr.Chan, and there are various groups who can be blinded inany given trial. But the phrase ‘double blind’ is really abuzzword without a hard meaning, he says. “They havedone surveys of textbooks and experts asking what 'doubleblinding' means to them and they have found almost 20 dif-ferent definitions that pick and choose two to three of thosegroups. The term should be avoided.”

LOOK FOR INTENTION TO TREAT ANALYSIS

“We want to make sure that all enrolled patients are in-cluded,” says Dr. Chan. “There is no point in developingthis random sequence and enrolling patients if you’re goingto start excluding them. That violates the randomization.”

BEWARE THE SUB-GROUP ANALYSISSub-group analyses, looking at fractions of the overalldata based on one or more distinguishing criteria, “arecommonly reported but they are very problematic, so itis important to approach them with caution,” says Dr.Chan.


skindaily Dermatopathology: Updated Concepts and Dilemmas, presentation by RinoCerio, BSc (Hons), MBBS, FRCP (Lon), FRCP (Edin), Queen Mary’s University of London,U.K., today (Friday, June 10), 10:30 a.m.


HOW TO EFFECTIVELY EVALUATE STUDIES

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THE SKIN MICROBIOMEobviously discovered a new kindof link which is important for ourunderstanding of the overall con-trol of the microbiome in the skinin these particular patients.”

Many published research pa-pers have shown that the more di-verse the skin microbiome is, thehealthier the skin tends to be, saysDr. Bieber. However, “during theflares of AD the [microbiome] di-versity is decreasing dramatically.And at the same time there is adramatic increase in the coloniza-tion of Staphylococci. Whetherthis is the cause or the conse-quence is still not clear.”

PROTECTING MICROBIOMEDIVERSITY IMPORTANT

“However, based on this knowl-edge, we are already thinkingabout strategies to modulate, to re-store, to appease, to improve themicrobiome in different ways.”

At a basic level, pro-activetreatment of flares, withtacrolimus, for example, can helpprotect microbiome diversity, saidDr. Bieber.

Looking at addressing in-flammation more directly, it maybe possible to create an emollientthat could contain microbiome-derived components that couldimprove clinical score in AD pa-tients, Dr. Bieber said, analogousto the fecal transplant therapiesthat have been successful in man-aging Cloristridium difficile infec-tions of the gut.

“The problem is we don’tknow really what happens exactlyat that level, and how does thiswork,” he said. The skin micro-biome is tremendously change-able, varying by region on thebody, acquiring new bacteriathrough contact, and from the air,he added.

“I think besides the allergic

aspects in AD, for us as dermatol-ogists to explain to our patientsthat the control of the disease isthe goal,” says Dr. Bieber. Derma-tologists can control inflammationthrough pro-active management,they can control xerosis, and thereis hope that they can improve orrestore the microbiome throughvarious strategies, he says.

However, “I think we shouldnot think only in terms of treat-ment, but in terms of preventio.There are a number of paperscoming out now which suggestthat in fact it is possible to preventthe emergence of this disease bythe very early intervention, solelyby using emollients,” and prevent-ing the atopic march from the be-ginning.

continued from page 3

continued from page 1

Women’s Dermatologic Society celebratesfour Women Leaders in Dermatology

(l-r) Dr. Rashim Sarkar, India, Dr. Marcia Ramos, Brazil, Dr. Christa DeCuyper, Belgium (absent), and Dr. Wilma Fowler Bergfeld, uSA, iidentifiedby the Women's Dermatologic Society as leading women in dermatology,pose in front of a mural painted by Miss Me Art during the WCD.

Real-time video updates streaming right nowand updated continuously


www.

THE FUTURE OF BEAUTY: SKIN HEALTH MONITORING

Prevention is a difficultmessage to convey toconsumers, especially whenevoking damage visible in 10,20 or 30 years.

In its researchlaboratories based in 6 regions around the world,L’Oréal is anticipating the future of healthy skinand hair, exposed and subjected to multiplestresses and the passing of time.

No single scientific or technological progresshas been overlooked:the concept of theexposome,knowledge of the skinmicrobiome, the harmful effects of light andpollution, differences in ethnicity and gender,hormone status, skin engineering, non-invasivemicroscopy, healthy chemistry, the clinical impactof a rejuvenation procedure, etc., but also andabove all bioelectronic sensors and actuators forconnected health.

This progress is inevitable as the skin is thelargest organ outside the human body and afterdecoding and sequencing the genome,digitalization will be essential for processing dataand customization.

With various renowned scientific partners,L’Oréal is furthering knowledge and makingimportant discoveries such as the role of the upperdermis and stem cells, new AOx pathways, therelevance of glycobiology, individual responses,etc. With big-data start-ups, performanceevaluation is entering a new era. The L’Oréalgroup is converting these advances into innovativeproducts for its worldwide brands.

To the simple question: what is eachperson’s skin exposed to?

L’Oréal Research & Innovation is providingconcrete answers with an in-depth understandingof the role of long UVA rays, visible light andpollution translated into formulas that combinefilters and antioxidants and customization usingconnected devices.

You can find us and brands such as La RochePosay, Skinceuticals, Vichy, Clarisonic, L’OréalParis and Kiehl’s during academic sessions,symposiums and on the exhibition area.

A big thank you to all the dermatologists andscientists with whom we have been able toelucidate the physiological mechanisms and makeprevention and treatment as effective aspossible to preserve beautiful skin.

A MATCH MADE IN MEDICINE:IDENTIFYING THE BEST FIT FOR YOUR PLAQUE PSORIASIS PATIENTS

Please join Celgene on Wednesday,June 10, from 5:00-7:00 PM, for AMatch Made in Medicine:Identifying the Best Fit for YourPlaque Psoriasis Patients, a

symposium that will evaluate the current treatmentlandscape and discuss key considerations for use ofconventional and new treatment options in certainpsoriasis patient types. The clinical profile of a novel,oral therapy for patients with psoriasis will bepresented, and physicians’ real-life experiences withthis therapy will be discussed. Attendees will gainessential knowledge of the clinical profile of thisnovel therapy and have the opportunity to participatein a discussion about appropriate treatment optionsfor different psoriasis patient types.

P&G AND DERMATOLOGISTSWORKING TOGETHER TOADVANCE SCIENCE, INNOVATIONAND PATIENT SOLUTIONS

P&G welcomes all delegates toVancouver and cordially invites youto visit us at Booth 301 to learn moreabout the science behind worldleading brands in skin, hair and

grooming from Head & Shoulders; Olay; Gillette;Pantene; SK-II; Braun; Wella.

Please join us at one of four satellite symposiawhere you will be able to learn more about theimpact of oxidative stress on your patient’s scalp andhair health or be inspired by our latest researchinsights, revealed by Systems Biology, into SkinHealth and Ageing. Take the opportunity to build yourknowledge on the best practices and options formale facial shaving or discover how we are usinginnovation to help reduce the risk of hair dye allergywith new ME+ technology.

STIEFEL: HELPING MORE PEOPLE DISCOVER AND ENJOY HEALTHY SKIN

Stiefel is a global leader in skinscience and a gold sponsor of WCD.We focus on the dermatologicalneeds of individuals, combining ourskin science expertise with

breakthrough innovation, to deliver a portfolio ofprescription medicines and daily skincare products.Visit booth 1417 to experience the Stiefel approachto addressing different skin needs.

We also invite you to the Stiefel Lecture Series.Each 20-minute expert-led interactive lunchtimesession will explore a different aspect of skin health,including innovative technologies in dermatology,understanding patient expectations in acne and thepsychological impact of chronic hand eczema.For media interview requests, please visit the Stiefelbooth. For WCD updates follow us @stiefelagskco.

DiamondSponsor

GoldSponsor

GoldSponsor

GoldSponsor

FROM THE 23RD WCD SPONSORS

Route 1Westin Bayshore VancouverCoast Coal HarbourLoden Hotel

Route 2 Coast Plaza Hotel & SuitesEmpire Landmark Listel Hotel VancouverCarmana PlazaShangri-la Hotel

Route 3 Sheraton Vancouver Wall

CentreCentury Plaza Hotel & SpaThe Sutton Place Hotel

Route 4 Four Seasons HotelMetropolitan Hotel VancouverRosewood Hotel GeorgiaWedgewood Hotel & SpaExecutive Hotel Le SoleilFairmont Hotel VancouverHyatt Regency

Route 5 Sandman Suite on DavieHoliday Inn & Suites Vancou-

ver DowntownResidence Inn Vancouver

Downtownopus VancouverBest Western Plus Down-

townExecutive Hotel Vintage Park

Route 6 Rosedale on Robson SuitesGeorgian Court Hampton Inn & SuitesSandman Hotel Vancouver

City CentreYWCAThe St. RegisDelta Suites Vancouver Ramada Limited Downtown

Vancouver

Route 7 uBC – Gage ResidenceuBC – Vanier Residence

Walking Hotels (no shuttleservice)

Days Inn Vancouver Down-town Hotel

Fairmont Pacific Rim HotelFairmont Waterfront HotelPan Pacific Vancouver HotelVancouver Marriott Pinnacle

Downtown HotelPinnacle Harbourside Hotel

Shuttle service for the WCDGala Event and the Presi-dent’s Banquet boardon street level in front of theVCC West Building and at theHyatt Regency Hotel.

For emergencies related toShuttle Bus Service, contactCarol 778-386-7449

Every 15minutes

Every 30minutes

Every 15minutes

Sunday,June 8

06:30 –08:30

08:30 –16:30

16:30 –21:30

Monday,June 9 toFriday,June 12

06:30 –10:30

10:30 –16:30

16:30 –19:30

Saturday,June 13

06:30 –10:30

10:30 –15:30

15:30 –17:30

• uBC shuttles run every 30 minutes during hours of opera-tion.

• Schedules maybe affected by traffic. We apologize for anydelays.

• official WCD 2015 name badges must be displayed to boardShuttle Bus.

Getting around

Taxi ServicesVancouver Taxi www.avancouvertaxi.com

(604) 871–1111Black Top + Checker Cab www.btccabs.ca

(604) 731–1111Yellow Cab www.yellowcabonline.com (604) 681–1111

skindaily •www.derm.city Saturday, June 13, 2015 • 13

UPDATE ON BCC (CLINICAL AND GENETICS)

Jean Tang, USA

l BCCs are driven by malignant activationof the Hedgehog signaling pathway.

l New drugs that target the Hedgehog sig-naling pathway are effective against ad-vanced and metastatic BCCs and alsoeffective in the treatment and preventionof BCCs in BCNS/Gorlin Syndrome. Pa-tients should be warned about the com-mon side effects, such as muscle cramps,taste loss and hair loss.

l Tumors evolve resistance to targetedtherapy and there is no clear second linetherapy.

SY52—Update on AK, BCC, and SCCFriday, June 12, 2015 13:30 to 16:30 Location: West Ballroom BCD

ANDROGENS AND THE SCALPWilma Bergfeld, USA

l Androgens can induce miniaturization ofscalp hair, while body can be enhanced.

l Signs of SAHA (Seborrhea, Acne, Hir-sutism and Alopecia) are associated withcirculating and pilosebaceous unit metab-olism of androgens. Circulating androgenswith SAHA signs are not always elevated.

l The hair follicle and sebaceous glands (pi-losebaceus unit) are affected by its mi-croenvironment which includes stromal,vascular and neurogenic influences ongrowth. Other factors include hormones(androgens such as testosterone, DHEAS,progesterone, prolactin, stress hormones,vitamin D), inflammatory cytokines, nu-trients, and prostaglandins. Evaluation ofpatients with androgen-induced scalp dis-orders is time consuming but rewarding.

l Understanding the subject’s individuality,emotional and disease stress, diseases,age, hereditary, diet and local factors arekey in developing a successful treatmentplan.

l Utilization of a multifaceted treatmentregime and managment program is es-sential for a successful outcome.

SY49—Women’s issues—From PCO to estrogen replacementFriday, June 12, 2015 07:30 to 10:00 Location: West Ballroom BCD

SKIN DISEASE CLASSIFICATION FROMWILLAN AND PLENCK TO ICD-10

Filippa Nyberg, Sweden

lA well-structured and accurate terminol-ogy is vital for any area of scientificstudy, for dermatology as much as forany other discipline.

lMuch progress in naming and classifica-tion of skin disease was made in the 18thand 19th centuries, particularly by Plenckin Austria and by Willan and Bateman inBritain.

l Despite major advances in medicine anddermatology in the 20th century, opportu-nities to improve representation of skindisease in the International Classificationof Diseases (ICD) were missed: how didit come about that ICD-10 enabled aneto-derma of Schweninger-Buzzi to be distin-guished from anetoderma ofJadassohn-Pelizzari but did not allowbasal cell carcinoma to be coded?

l The lack of a comprehensive, logical andinternationally standardized terminologyfor skin disease has hampered advancesin understanding and management ofskin disease.

WS69—International Classification of Diseases (ICD)—ICD 11 for DermatologyFriday, June 12, 2015 14:30 to 16:30 Location: East 16


Pearls to take home from the 23rd WCD


skindaily Geriatric Dermatology: Find out what’s new in Geriatric Dermatology at thesession on Saturday, June 13 from 8 to 10, in West 208–209. Tell your colleagues what you learnedat www.derm.city, “Where dermatology lives”

A recently published monograph edited by Drs. W. Stuart Maddin and H. EileenMurray of Vancouver outlines more than 50 international innovations which haveshaped modern dermatology. The stories are told by fig-ures at the forefront of the research. Dr. John Kraft ofMarkham, Ont. recently spoke on behalf of skindailywith Dr. Gary L. Peck of Washington, D.C., who con-tributed the chapter on isotretinoin.

What do dermatologists and patients owe toisotretinoin?Isotretinoin has long been known to be ahighly effective therapy and even a cure foreven the most severe cases of previously un-treatable patients with nodulocystic and con-globate acne. By treating these patients earlywe can prevent the physical and psychological scarring that this dis-ease process produces. Thus, isotretinoin has become an essentialmedication for the dermatologist to offer his patients and the patientsnow have hope that their acne can be arrested promptly and safelywith appropriate close supervision and that they can proceed withtheir lives unhindered by pain and disfigurement. In addition,isotretinoin and other retinoids have been effective therapy for cuta-neous disorders of keratinization and in skin cancer prevention.

What obstacles or challenges were faced during the discovery ofthis therapy?Hyperlipidemia and a few cases of depression were discovered prior tothe approval of isotretinoin for acne and its subsequent marketing in Sep-tember, 1982. The first cases of birth defects came in the spring of 1983.Later on, cases of suicide were reported and, more recently, cases of in-flammatory bowel disease during isotretinoin therapy led to additionallawsuits. In addition, the only toxicity from long-term usage of isotretinoinare changes resembling diffuse idiopathic skeletal hyperostosis.

What refinements or improvements to the therapy do you anticipateduring the coming years?

The drug has been on the market since Septem-ber, 1982. Most of the refinements in dose sched-ule, spectrum of responsive diseases beyondacne, spectrum of acute and chronic toxicitieshave in large measure already occurred. Thirtyyears ago, I was told that Roche had 5,000 syn-thetic retinoids that were to be tested for even-tual systemic use. I expected that a newerretinoid that would have been more effective orsafer than isotretinoin would have come to mar-ket. I remain surprised that isotretinoin is theonly retinoid to date that is effective in the treat-

ment of nodulocystic acne. Moreover, the therapeutic spectrum of theretinoids has gone beyond dermatology, mainly into the realm of oncol-ogy. I consider it an accident of history that the retinoids were first devel-oped in dermatology. I expect the list of responsive diseases to isotretinoinand other retinoids to grow. I was told by Dr. John Strauss that Rocheabandoned its 5,000 retinoids due to the isotretinoin law suits. It is myhope that other pharmaceutical companies will study retinoids, perhaps inoncology where the retinoid toxicities may be moretolerable. I would also hope that retinoids are ap-proved by the FDA for other indications, such as cu-taneous disorders of keratinization. In addition, basicresearch into the mechanisms of action of theretinoids should be supported.

To Heal the Skin: The Heroes Behind Discoveriesin Dermatology, Buffalo NY: Linacre's Books,2015. 400 pp, uS$79.95 More information:http://www.tohealtheskin.com

In tomorrow’s e-edition ofskindaily•Planning begins for 24th WorldCongress of Dermatology, 2019• Reports from this evening’s WCDGala Event•WCD 2015 summaries & mementos

Tomorrow’s “paper” is only available electronically.Delivered directly to your tablet, smartphone or device..

Exclusively for WCD delegates.

Sign up now at www.derm.city

“Where Dermatology Lives.”

Keynote lecture

by Dr. John

McGrath, to

discuss genetic

technologies

by EMILY INNES

for skindaily

VA N C o u V E R—A professor of

molecular dermatology at King

’s

College London will be encourag

-

ing dermatologists to embrac

e

new technologies in genetics dur

-

ing his keynote lecture on Tue

s-

day, June 9. Dr. John McGr

ath says as a

result of new genetic technolog

y

the days of not having an expla

-

nation for a genetic condition ar

e

quickly becoming history. Clin

i-

cians now have the opportunit

y

to conduct tests to determine

a

patient’s particular mutation

,

which can lead to better and tar

-

geted therapies.

“Dermatologists should in-

corporate genetics into their pr

o-

fessional lives with som

e

en thusiasm rather than with som

e

despair,” says Dr. McGrath, hea

d

of King’s College London’s Ge

-

netic Skin Disease Unit. “Thos

e

days of ignorance and not bein

g

able to do anything [for patients

]

are passing. Now there are som

e

very real, here and now, [actions

]

that we can take in terms of diag

-

nosis and counselling and, befor

e

too long, deliver better therapie

s.

It is a changing world for derma

-

tology and genetics.”

More accurate Dx

Technology called whole exom

e

sequencing, part of next genera

-

tion gene sequencing, allow

s

clinicians to make more accu

-

rate diagnoses for patients wit

h

rare but also common cond

i-

tions, such as eczema and psor

i-

asis. Next generatio

n gene se-

quencing is a routine blood test

,

but the challenge is understanding

the genetic information on the re

-

port, says Dr. McGrath. While h

e

says modern-day dermatolog

y

MondayJune 8 2015

skindailypowered by skinchronicleinternational

Basil cell carcinoma

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bibendum lacus nec orci

egestas, vel tristique quam

facilisis.

11 am today: Dr. Zoe

Draelos Vivamus dignissim

neque lectus, vitae elemen-

tum diam posuere ut. Nulla

sed augue eleifend, sollici-

tudin purus non, accumsan

nibh.

Dr. Frederic Mohs Donec

ac est ultrices, blandit ipsum

non, laoreet felis. Maecenas

posuere, nulla vel sodales

semper, enim elit iaculis

lorem, eu volutpat.

2 pm tomorrow:

Device data released

Etiam et sodales tortor, a ve-

hicula dolor. Integer male-

suada quam sit amet risus

consequat eleifend. Nulla fa-

cilisi.

6

8

11

14

A message from

Dr. Jerry Shapiro,

President, and

Dr. Harvey Lui,

Secretary-General

VA N C o u V E R—On behalf of

the Canadian Dermatology Asso

-

ciation (CDA) and the WC

D

2015 National Organizing Com-

mittee, we are delighted to ex

-

tend a warm welcome to

beaut iful Vancouver and the 23

rd

World Congress of Dermatolog

y

(23rd WCD). The World Congres

s

of Dermatology is the world

’s

oldest and continuous interna

-

tional dermatology meeting an

d

now takes place every four year

s.

The first Congress in Paris i

n

1889 pre-dated the moder

n

Olympics by seven years, an

d

was last held in North America i

n

1992.Four years ago

in Seoul, the

International League of Dermato

-

derm.city

www.

Info onthe go

Get hourly World

Congress news

updates via Twit-

ter, plus daily pod-

casts, images and video re-

ports sent directly to your

mobile device. Only at

www.derm.city

“Where Dermatology lives”

Todayat the World

Congress

by DR. CHARLES LYNDE

EDITOR of skindaily

Welcome to Vancouver, to the

23rd World Congress of Der-

matology, and to the first edi-

tion of SkinDAILY, the Official

Newspaper of this conference.

Very much like the city in

which we have convened, the

SkinDAILY intends to be ex-

pansive in its vision, pleased

to engage all voices and all in-

terests, unapologetic in its cu-

riosity, and ready, willing and

eager to try new things.

One such new thing is as

close by as your mobile de-

vice. That is SkinDAILY’s mo-

bile-friendly digital news and

networking hub, located at

www.derm.city.

(That is not a

typo, and you

have no need

to add a “dot-

com” when

WELCOME TO VANCOUVER:Greetings

from WCD National Organizing Committee

Dr. Jerry Shapiro (l),

and Dr. Harvey Lui (r)

1Vancouver Art Gallery

: Architecture of Herzo

g & de

Meuron Aenean pulvinar, orci

at semper dignissim, sem leo tris

-

tique enim, vel euismod lectus ur

na et nisi.

2Seasons in the Park d

ining Curabitur consequat non

lorem eget consequat. In condim

entum scelerisque eros nec

gravida. Maecenas vel lacinia eli

t, non convallis elit. Suspendisse

sagittis feugiat venenatis.

continued on page 4

continued on page 6

continued on page 6

5 more reasonsto be glad y

ou’re in Vancouver toda

y

OFFICIAL NEWSPAPER OF THE 2323RDRD WWORLDORLD CCONGRESSONGRESS OFOF DDERMATOLOGY

ERMATOLOGY

continued on page 4

GENODERMATOSES: Discoveries

will lead to better and targeted therapies

derm.city

www.

Speaking of DiscoveriesDr. John Kraft in conversation with Dr. Gary L. Peck

USA $79.95Canada $99.95

UK £57.50Éire and EU €70

Tubes, jars, and containers of skinmedications and products are likelythe most common objects found inyour household medicine cabinet. Billions are spent each year by patients and consumers on thesepreparations, and billions more areinvested by scientific developers inthe search for better cures for skin ailments, and the effects of aging. Forall that ubiquity, little attention is paidto the people and the processes behind these medicines.

In To Heal the Skin, the renowned medical specialists W. Stuart Maddinand H. Eileen Murray have assembled a truly stellar body ofmore than 50 acclaimed international researchers and practitioners, and spearheaded theirmission to seek out the often-unknown or overlookedstories of the origin of many of theworld’s most widely used dermato-logic medicines. The result is a fascinating and authoritative look intothe private places from which emergediscoveries that improve our lives.

0515

It ’s a fac t that physicians and residents,pharmacists, patients and the public at large don’t often showvery much curiosity about the genesis of the therapies wecommonly use. It’s also a fact that behind every significantdrug discovery you will find a minimum of several fascinating stories.

For my part, my child-like curiosity concerning thehows and whys of these innovations has only intensifiedover the years.

The purpose of this book is to take some of the majortreatment agents and find out from the investigators asmuch as possible. Who struck upon the concept?How was it done? What were the hurdles?

And, most tellingly, who were the individuals behindthese discoveries? What is their personal story?

“

”

From W. Stuart Maddin’s preface to

To Heal the Skin

W. Stuart Maddin is ClinicalProfessor Emeritus at the Departmentof Dermatology and Skin Science (Active), Faculty of Medicine,University of British Columbia,Vancouver, Canada

H. Eileen Murray is Professor, University of Manitoba, Canada, andAdjunct Professor, University of British Columbia, Department of Dermatology and Skin Science

Front cover design, David Stambler

Linacre’s BooksAn imprint of Chronicle Companies

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W. STUARTMADDIN, MD, FRCPC

H. EILEENMUR"Y, MD, FRCPCEditors

JS_05-15-15_cover4_Layout 1 5/19/2015 2:55 PM Page 1


Dr. Kraft Dr. Peck

Polls-a-plenty: Express your opinions on whatyou’ve seen and learned at WCD 2015


www.

Best 5 sushi places1. Dream Sushi, 4401 MainStreet and 4385 DunbarStreet, www.dream-sushibc.com2. Octopus’ Garden, 1995Cornwall Avenue, www.oc-topusgardensada.com3. Tojo’s, 1133 W. Broad-way, www.tojos.com4. Sushi Maro, 220 DavieStreet, www.sushimaro.com5. Blue Water Café, 1095Hamilton Street, bluewa-tercafe.net

Best 5 workout places 1. Yyoga, 888 BurrardStreet and 1050 HomerStreet, #280, www.yyoga.ca2. Grouse Grind, challeng-ing 2.9-kilometer trek to

top ofGrouseMountainoften called ‘Mother Na-ture’s Stairmaster,’ www. -grouse mountain.com/grousegrind3. The Back Healerwww.thebackhealer.com4. The Bar Method van-couver.barmethod.com5. Run/walk/bike the Seawall: vancouver.ca/parks-recreation-culture/sea-wall.aspx

Best 5 cocktail places 1. The Keefer Bar, 135Keefer Street, www.the-keeferbar.com2. Reflections, 801 WestGeorgia Street, www.rose-woodhotels.com/en/hotel-georgia-vancouver/dining/reflections3. The Diamond, 6 PowellStreet, di6mond.com4. Bridges, 1696 DuranleauStreet, www.bridges-restaurant.com5. The Parlour, 1011 Hamil-ton Street, theparlour-restaurants.com

Best 5 spas1. Fairmont Willow StreamSpa www.fairmont.com/explore/spa/willow-stream-spa2. Miraj Hammam Spa,1495 West 6th Avenue,www.mirajhammam.com3. Chi, The Spa, 1128 WestGeorgia Street,www.shangri-la.com/van-couver/shangrila/health-leisure/chi-the-spa4. Breathe Spa, 464Granville Street,www.breathespa.net5. Wedgewood Hotel Spa,845 Hornby Street, www. -wedgewoodhotel.com/spa-wedgewood

in VancouverWhere to eatSkinDAILY asked local restau-rant blogger Sherman Chan for adining recommendation near thecongress. He thought of Wilde-beast, an award-winning newrestaurant offering what’s de-scribed as a “meat-centric, off-cutfarmhouse fare.” Here are someextracts from his recent review.

We started with a few smallappetizers, including the

spiced pork rinds. These wereserved majestically in a metal cupwhere they ate as good as theylooked. Light, crispy and airy,each bite melted in my mouthafter the initial crunch. There wasno absence of seasoning wherethere was some sweet and saltysmokiness going on. Next, wetried the poutine [a Quebec dishconsisting of gravy-soaked, curd-covered French fries, which somecall the National Meal ofCanada.] It was the beneficiary ofa good amount of cheese curds. Icouldn’t tell if they were squeakyor not since they had all melted.With a sprinkle of black pepper,the gravy was both salty and pep-pery. As much as the fries werefresh-cut, I would’ve preferredthem to be crispier.

Onto our mains, I went forthe seared venison with roastedcauliflower purée, grainy mustardspätzle, Belgian endive and natu-ral jus. Prepared a propermedium-rare, this ensured thatthe lean venison would be succu-lent and sufficiently tender. Onthe outside, there was a flavorfulbark from the ample sear whichadded a smokiness to the meat. Ithought the cauliflower pureewas impactful with a naturalsweetness. With a fluffy reboundand a crisp crust, the spätzle waswell-executed. Portion sizesweren’t exactly large, but theywere adequate. We received re-ally good, unpretentious service.

120 W. Hastings St., (604) 687–6880

More reviews at:www.shermansfoodadven-tures.com



skindaily Men’s Health: Presentations on male skin health scheduled for tomorrow (Saturday,June 13) from 8 to 10:30 in West 220-222. Tell you colleagues what you learned at www.derm.city,"Where dermatology lives"

1. Japadog (530 Robson St.) A Vancouver original imported fromJapan. Unique and delicious hot dogs originally available only froma street cart, but the business now has a permanent location on fash-ionable, bustling Robson Street.2. Cafe Medina (780 Richards St.) Known for their breakfastand brunch, the lineup for a table here can be daunting but thefood is worth it.3. La Taqueria (2549 Cambie St.) Vancouver is not known forits Mexican food but this spot—which serves only tacos—is certi-fied authentic.4. Nuba (four locations, 207 W Hastings St. is closest to the VCC).Lebanese food (vegetarian friendly). I recommend trying Najib’sspecial.5. Hubbub sandwiches (859 Hornby St.) Simply delicioushealthy sandwiches and salads.ing. There are also a number ofcafes that serve 49th Parallel coffee. One of the best bets is BelCafe.

contributed by Dr. Katie Beleznay, dermatologist

5casual dining places

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1. From the top of Grouse Mountain. There are twoways to the top: by gondola or you can choose to accept thechallenge of doing the Grouse Grind and climb up. It’s a greatworkout and the reward of the view at the top is worth it. Plus,doing “The Grind” will make you a true Vancouverite.2. Coming over the Lions Gate Bridge at night. You’llget the view in the daytime on your way back from Grouse Moun-tain but there is something special about the city lights at night.3. Gazing across from Spanish Banks. It’s worth a tripover to enjoy the beach but looking back toward downtown Van-couver always reminds me what a beautiful city Vancouver is.4. Anywhere on the sea wall. Take a walk around the seawall that encircles downtown Vancouver and you will haveplenty of great views.5. Stanley Park. Take a jaunt in to the park and you’ll feellike you’re out of the city altogether.

Dr. Katie Beleznay’s

favorite views of Vancouver

Dr. Shannon Humphrey’s

Best of Vancouver

Dr. Gulliver’s Travelsat the 23rd World Congress of Dermatology


skindaily Geriatric Dermatology : Find out what’s new in Geriatric Dermatology at the ses-sion on Saturday, June 13 from 8 to 10, in West 208–209. Tell your colleagues what you learned atwww.derm.city, “Where dermatology lives”


5:00 am As my week at the World Congress stretches on, I'mcertain I'm not the only delegate who has found himself in the sameposition as Bill Murray in the film “Groundhog Day.” In that movie, Mur-ray landed in a never-ending cycle of weariness, followed by a few sec-onds of respite, and immediately thereafter an early wake-up alarm, inthe form of Sonny and Cher singing “I Got You Babe.”

This all seemed hilarious when I saw it depicted on a movie screenyears ago, but this morning I can see where the repetitive nature of eachday's routine might take a toll on some. I dress for the day's events andtry to decipher the notations I made on the back of my registrationbadge. It’s unclear to me whether I've scheduled a breakfast meeting atDenny's and happy hour at Joey Bentall, or if the order could be re-versed, or whether those might be the names of colleagues I en-countered during yesterday's scientific sessions. Fortunately, Ihave the entire day ahead to try to figure it all out.

6:00 am I step out into another sparkling VancouverFriday morning, and am exhilarated and refreshed by the un-mistakable scent of the sea in the air. As some readers know,I happen to practice and reside on the other side of this greatcountry, on an island in the Atlantic known as Newfoundlandand Labrador. I sincerely wish I knew how Drs. Harvey Lui andJerry Shapiro managed to arrange the weather in Vancouverthis week—the entire stretch of the WCD has been nothing but

sunshine and clear weather. I’m not giving anything away to anyone whoknows anything about Vancouver, because many of us have visited herewhen the weather has been quite otherwise, and an observer could noteven make out the mountains over the North Shore. If I could take Har-vey and Jerry’s little weather secret back to Newfoundland andLabrador, I could sell it to the visitor bureaus and the owners of the off-shore oil rigs and fund my genomics research for the next 25 years.

3 pm One day to go at the 23rd World Congress of Dermatology.The overall impression of this Congress, and I’ve discussed this with manyof my colleagues throughout the week, is that the scientific sessions andposter presentations have been unparalleled. Excellent information, in-triguing speakers, and a wide array of topics with appeal to all interests indermatology. The program organizers should be congratulated.

We learned on Wednesday that Milan has won the biddingprocess to host the 2019 WCD, and I’ll look forward to seeing you

there. In the meantime (and four years can be a long time in der-matology), let me know about your observations on develop-ments in our specialty, which, as we learn more aboutco-morbidities associated with skin disease, may finally receivethe recognition in the medical community that has been so richlydeserved. You can reach me at the co-ordinates below.

Dr. Wayne P. Gulliver is Medical Editor of Skin Chronicle Interna-tional. Follow him at the WCD on Twitter. Go to www.derm.city

www. .com

SkinDAILY_Jublia_Tennis_US_Ad_May1_1.0.indd 2 2015-05-01 2:50 PM

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