- Email: [email protected]
PL001 Androgenic disorders
Sl
Plenary Lectures
PLO01 Androgenic disorders T.J. McKenna. St. Vincent’s
Hospital,
Dublin
4, Ireland
Androgen excess is characterized clinically by hirsutism, acne, alopecia, increasing muscle bulk, deepening of the voice and clitoromegaly. The causes of androgen excess include idiopathic hirsutism (IH)/polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), Cushing’s syndrome, androgensecreting tumours of the ovaries and the adrenal glands. Greater than 95% patients presenting with an androgenic disorder have mild excess associated with IIUPCOS. These usually can be recognised clinically by the occurrence of slowly progressive hirsutism presenting in the decade between 15 and 25 years of age with (PCOS) or without (IH) menstrual disorders and are never associated with virilisation. For the patient presenting with the typical features of IH/PCOS the diagnosis can be made clinically. If it is decided to screen for more sinister disorders measurement of the testosterone (T): sex hormone binding globulin (SHBG) ratio is the test of choice. When hirsutism presents with atypical features investigation is indicated. Investigations include the measurement of TSHBG, dehydroepiandrosterone sulphate, imaging of the adrenals and ovaries. In some ethnic groups it is advisable to measure an early morning 170H-progesterone level or the 170H-progeserene response to stimulation with ACTH to screen for CAH. Normal suppression of cortisol following administration of dexamethasone 1 mg at midnight excludes Cushing’s syndrome.
PLO02 Recent advances in psoriasis E. Christophers. Dept. of Dermatology,
University
of Kiel,
Germany
Psoriasis is a common skin disease of which possible pathogenetic mechanisms still are under discussion. Recently major insight into pathophysiology was provided by localization of susceptibility gene loci on several chromosomes in familial psoriasis. These findings support the multifactorial nature of psoriasis In addition, substantial evidence is provided by immunopathology studies showing that T-cell-autoimmunity plays 1 major role. Finally, therapeutical regimens such as cyclosporin A, FK 506, fumerates as well as bath PUVA and vitamin D derivatives have shown to possess a distinct mode of action. Taken to the other these findings have helped in the understanding of the pathophysiological complexity of psoriasis.
PLO03 Recent advances in the understanding of melanogenesis and melanin pigmentaty disorders J.-P. Ortonne. U385 INSERM, Dermatologie,
Hdpital
Faculte’de de 1‘Archet, Nice,
Mddecine, France
Service
de
The past decide has brouhgt a great deal of new knowledge regarding the biochemistry of melanins, the regulation of melanogenesis, and the biology of melanocytes. This progress is largely due to the ability to grow normal human melanocytes in culture. Mutations affecting mouse coat colour have been characterized in recent years. The wealth of genetic information arising from these studies has been an impetus for understanding the enzymology, cell biology, and developmental biology of melanocytes and melanin synthesis. Most of the data obtained in mouse melanocytes can be extrapoled to their human counterparts. They have led to the discovery of new growth factors of regulatory proteins influencing human skin colour and to a better knowledge of the pathophysiology of hereditary and acquired disorders characterized by disturbances of skin melanin pigmentation. The genes involved in several pigmentary genodermatoses, including piebaldism, Waardenburg’s syndromes, different forms of oculo-cutaneous albinism, Hermansky-Pudlak, etc have been identified as well as candidate genes for other unusual disorders such as Griscelli-Prunieras syndrome. The cloning of the agouti and MSH receptor genes will also be most informative, for the molecular characterization of human phototypes as suggested by recent investigations. Melanocytes have long been considered as highly specialized cells with the unique function of synthesizing melanins. Accumulating evidence suggest that melanocytes display a considerably wider range of secretory activities than those involved in melanin production. They are capable of producing a variety of biologically active compounds. Other findings suggest that melanocytes are active participants in the skin immune system. These observations throw new lights for our understanding of acquired melanin pigmentary disorders such as vitiligo, melasma, post-inflammatory dyspigmentation, pigmentary abnormalities of chronologically and photodamaged skin.
PLO04 Wound healing M.W.J. Ferguson. School Manchestel; Manchester
3.239 Stopford Ml3 9PT, UK
of Biological Building,
Sciences, University Onford Road,
of
Wound healing presents two major clinical problems: chronic wounds which fail to heal and scarring following acute or chronic wounds. This presentation will concentrate on novel
Plenary Lectures
PLO01 Androgenic disorders T.J. McKenna. St. Vincent’s
Hospital,
Dublin
4, Ireland
Androgen excess is characterized clinically by hirsutism, acne, alopecia, increasing muscle bulk, deepening of the voice and clitoromegaly. The causes of androgen excess include idiopathic hirsutism (IH)/polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), Cushing’s syndrome, androgensecreting tumours of the ovaries and the adrenal glands. Greater than 95% patients presenting with an androgenic disorder have mild excess associated with IIUPCOS. These usually can be recognised clinically by the occurrence of slowly progressive hirsutism presenting in the decade between 15 and 25 years of age with (PCOS) or without (IH) menstrual disorders and are never associated with virilisation. For the patient presenting with the typical features of IH/PCOS the diagnosis can be made clinically. If it is decided to screen for more sinister disorders measurement of the testosterone (T): sex hormone binding globulin (SHBG) ratio is the test of choice. When hirsutism presents with atypical features investigation is indicated. Investigations include the measurement of TSHBG, dehydroepiandrosterone sulphate, imaging of the adrenals and ovaries. In some ethnic groups it is advisable to measure an early morning 170H-progesterone level or the 170H-progeserene response to stimulation with ACTH to screen for CAH. Normal suppression of cortisol following administration of dexamethasone 1 mg at midnight excludes Cushing’s syndrome.
PLO02 Recent advances in psoriasis E. Christophers. Dept. of Dermatology,
University
of Kiel,
Germany
Psoriasis is a common skin disease of which possible pathogenetic mechanisms still are under discussion. Recently major insight into pathophysiology was provided by localization of susceptibility gene loci on several chromosomes in familial psoriasis. These findings support the multifactorial nature of psoriasis In addition, substantial evidence is provided by immunopathology studies showing that T-cell-autoimmunity plays 1 major role. Finally, therapeutical regimens such as cyclosporin A, FK 506, fumerates as well as bath PUVA and vitamin D derivatives have shown to possess a distinct mode of action. Taken to the other these findings have helped in the understanding of the pathophysiological complexity of psoriasis.
PLO03 Recent advances in the understanding of melanogenesis and melanin pigmentaty disorders J.-P. Ortonne. U385 INSERM, Dermatologie,
Hdpital
Faculte’de de 1‘Archet, Nice,
Mddecine, France
Service
de
The past decide has brouhgt a great deal of new knowledge regarding the biochemistry of melanins, the regulation of melanogenesis, and the biology of melanocytes. This progress is largely due to the ability to grow normal human melanocytes in culture. Mutations affecting mouse coat colour have been characterized in recent years. The wealth of genetic information arising from these studies has been an impetus for understanding the enzymology, cell biology, and developmental biology of melanocytes and melanin synthesis. Most of the data obtained in mouse melanocytes can be extrapoled to their human counterparts. They have led to the discovery of new growth factors of regulatory proteins influencing human skin colour and to a better knowledge of the pathophysiology of hereditary and acquired disorders characterized by disturbances of skin melanin pigmentation. The genes involved in several pigmentary genodermatoses, including piebaldism, Waardenburg’s syndromes, different forms of oculo-cutaneous albinism, Hermansky-Pudlak, etc have been identified as well as candidate genes for other unusual disorders such as Griscelli-Prunieras syndrome. The cloning of the agouti and MSH receptor genes will also be most informative, for the molecular characterization of human phototypes as suggested by recent investigations. Melanocytes have long been considered as highly specialized cells with the unique function of synthesizing melanins. Accumulating evidence suggest that melanocytes display a considerably wider range of secretory activities than those involved in melanin production. They are capable of producing a variety of biologically active compounds. Other findings suggest that melanocytes are active participants in the skin immune system. These observations throw new lights for our understanding of acquired melanin pigmentary disorders such as vitiligo, melasma, post-inflammatory dyspigmentation, pigmentary abnormalities of chronologically and photodamaged skin.
PLO04 Wound healing M.W.J. Ferguson. School Manchestel; Manchester
3.239 Stopford Ml3 9PT, UK
of Biological Building,
Sciences, University Onford Road,
of
Wound healing presents two major clinical problems: chronic wounds which fail to heal and scarring following acute or chronic wounds. This presentation will concentrate on novel