geographic location, maternal viral burden, disease stage and breast feeding practices, vary from 1530%. Early diagnostic techniques have improved such that infection can be diagnosed in 90-95% of infected children by 2-3 months of age. Improved therapies mean that children can be more effectively treated resulting in improved quality of life and survival. Nonetheless, to date we have no cure, thus the importance of developing effective preventive strategies cannot be overstated. Zidovudine given to women during pregnancy and labour and to infants in the neonatal period reduces the transmission rate (25 to 8%). Use of more efficient antiretroviral agents might decrease this further. The importance of HIV exposure during delivery requires further evaluation. Meta-analysis of vertical transmission studies suggest that the mode of delivery could affect outcome and the results of randomised prospective trials evaluating this are awaited. This raises the exciting prospect that even more effective strategies of prevention will be available in the near future. I CO10 Update on keratin disorders P.M. Steijlen. University Hospital Nijmegen,
* Weber-Cockayne * Koebner * Dowling-Meara Bullous congenital ichthyosiform Epidermolytic epidennal naews Ichthyosis bullosa Siemens Pachyonychia
KYK14 KYK14 K5iK14 Kl/KlO KIO mosaic K2e
* Jadassohn-Lewandowsky * Jackson-Lawler White sponge naevus Steatocystoma multiplex Monilethrix
European Society of Dermatological Surgery: Surgical Management of Cutaneous Malignancy
Management of basal cell carcinoma. Surgical procedures
Francisco M. Camacho. University Sevilla,
Basal cell carcinomas (BCC) represent the most frequent malignant cutaneous tumor, the location of which always determines the surgical treatment to employ. Although the majority of BCCs should be removed with Mohs micrographic surgery, there are some which can be successfully treated by means of classical surgical techniques. The most usual locations of BCC involve the upper and middle part of the face: forehead, interglabellar region, temples, upper and lower eyelids, internal canthus, cheeks and nose. The most useful procedures of classical dermatologic surgery in relation with the location will be described.
There are at least 30 different keratins. They belong to the intermediate filament molecules and play an important role in maintaining the structural integrity of epithelial cells. Disruption of the interfilament network will lead to abnormal keratinization and decreased resistance of the epithelia to mechanical stress. The expression of keratins is differentiation and body site specific. Because of this the phenotype of disorders caused by keratin gene mutations varies greatly depending upon the particular keratin that is mutated. Epidermolysis bullosa simplex was the first disease which appeared to be caused by a mutation in a keratin gene. Shortly thereafter keratin mutations were identified in different forms of bullous ichthyosis. Mutant keratin genes introduced into transgenic mice mimicked the diseases. Later epidermolytic palmoplantar keratoderma and pachyonychia congenita, white sponge naevus and very recently monilethrix and a phenotype resembling steatocystoma multiplex were elucidated. Epidermolysis
K6aiK16 K17 K4IK13 K17 bHb6
Management of basal cell carcinoma: Mohs micrographic
Antonio Silva Picoto. Portugal Abstract not available.
Management of squamous cell carcinoma: Surgical procedures
J. Petres, R. Rompel. Department Clinics of Kassel, Germany
The majority of cutaneous squamous cell carcinomas (XC) are located in the head-neck-region and especially on the midface and ears. Surgical elimination of SCC should include the advantageous micrographic surgery in its variations. This may result in defects which can not be managed by primary wound closure. Therefore, further surgical techniques must be used. Local and regional flap plastics usually ensure a satisfying functional and esthetic reconstruction of the excised structures. The fundamental methods of padicled skin flaps like transposition flaps and advancement flaps are known since the last century. Meanwhile, these techniques have been refined and modified so that extended skin and soft tissue defects can be reconstructed following an uncompromising radical tumor elimination. According to our own broad experiences we present indications and applications of micrographic surgery and reconstructive techniques. Possible risks resulting from the neglection of principal anatomic and morphologic circumstances are shown.
CO14 Management of actinic keratosis and other pre-cancerous processes H.A. Martin0 Neumann. The Netherlands Oncology in dermatology is an increasing problem. Incidence and prevalence as well of all non-melanoma skin cancers as