- Email: [email protected]
ST004 Genital warts: A recurring problem — Imiquimod a new approach to treatment
S113
Satellite Symposia
ST001 Neurones and the skin - Future of neuro-dermato-cosmetology Tore110 M. Lotti. Dept.
of Dermosciences,
University
highlight the clinical relevance of Daivonex in these circumstances. of Siena,
Italy
Neurones in the skin release an heterogeneous group of molecules which is termed ‘Neuropeptides’ (NP). They act as neuromodulators, neurotransmitters, neurohormones and hormones and are both transported in the skin by nerve fibres or immune cells and locally synthesized (i.e. in keratinocytes, endotbelial cells, fibroblasts, melanocytes, Merkel cells etc.). It is easy to foretell that in the coming years the dermatologist and the cosmetologist will have to face an enormous amount of new basic information and related or suggested clinical applications of NP, agonists and antagonists. The therapeutic potentials of NP are exciting. Up to now several drugs are able to antagonise the effects of NP in the skin (i.e. capsaicin, peptide T etc.) or to exert some agonistic activities i.e. (Y-MSH, ACE-inhibitors, CGRP, Somatostatin) or to perform strong competitive inhibitory activity (i.e. Spantide). Many common skin conditions (i.e. psoriasis, allergic contact dermatitis, vitiligo, atopic dermatitis, sensitive skin, post-herpetic neuralgia, notalgia paresthetica, vulvodynia, pruritis aquagenicus etc.) will be probably successfully treated with NP, their agonists or their competitive inhibitors in the near future. Reference [I] Lotti T., Hautmann G., Panconesi E., Neuropeptides in skin, J Am Acad Dermatol 1995: 33: 482-496
ST002 Psoriasis - Therapeutic dilemma and solutions G.M. Murphy ’ , E. HGlzle *. ’ Dept.of Hospital, Dublin, Ireland, Oldenburg, Germany
*Stiidtische
Dermatology, Beaumont Kliniken Oldenburg,
Chairmen’s overview Psoriasis is a common disorder which at times poses complex management problems. Life-threatening erythrodermic or pustular psoriasis requires a variety of different therapeutic strategies dependent on the circumstances of the patient and the phase of the disease. Management of psoriasis may differ in pregnancy and childhood, and certain sites, such as face, flexures and scalp, require special therapeutic regimes. Non-compliance is an important reason for treatment failure in the management of psoriasis and disease fluctuation requires appropriate adjustment of treatment. This satellite symposium will delineate relevant effective therapeutic strategies for the various categories of psoriasis and
( ST003 ( Bacteria and the skin - Clinical practice and therapy update Kristian The&up-Pedersen. Marselisborg D., Denmark
Hospital,
Department of Dermatology, University of Aarhus, DK-8000,
Aarhus
We know that bacteriae are part of the normal skin flora. They seem to be nicely controlled by our skin lipids, our phagocytic cell system and our immune system. Actually, the greatest achievements within medicine have been the introduction of vaccines, whereby bacterial products are used to augment our defence systems. So - why bother about the skin flora ? We are only concerned, if the bacteriae give rise to boils, erysipelas, echtyma or other forms of ‘infection’. Skin infection is the clinical sign of our phagocytic cell system’s fight against aggressive and large amounts of bacteria. They are rather easily controlled by proper topical or systemic antibacterial therapy. However - the interplay between skin bacteriae and the immune system of patients with chronic inflammatory diseases seems to need more attention by dermatologists. The symposium will focus on important aspects and new observations of how bacteria can augment skin inflammation besides being causes for skin infections.
ST004 Genital warts: A recurring problem lmiquimod a new approach to treatment R.D. Maw. Royal
Victoria
Hospital,
Belfast,
Northern
Ireland
Anogenital warts have become one of the most common sexually transmitted diseases reported in the Western World. The frustration of treatment for both patient and carer is well recognised. Currently available methods rely principally on ablation of visible lesions, with often hospital-based treatments requiring multiple outpatient attendances. The failure rate, recurrence rate and side-effects of these treatments are totally unsatisfactory. Imiquimod represents the most interesting and innovative approach to therapy to become available in many years (recently launched in the US under the brand name Aldara’” cream). As it is an immune response modifier, this symposium addresses the vital issues of the immune based response to HPV infection, and the problems of persistence caused by HPV disease. The mechanisms by which Imiquimod can induce an inflammatory and cell-mediated response will be discussed, and the consequent clinical results show great cause for optimism for this treatment.
s114
Satellite
As a home-based effective treatment with a low recurrence rate we trust you will share our enthusiasm. We are sure that this symposium will be an excellent vehicle to share your thoughts and experiences of the treatment of genital HPV infections and to discuss the place for Imiquimod in clinical practice. A session not to be missed!
ST005 Tazarotene: A new topical receptorselective retinoid J.-P. Ortonne ’ , R. Marks ‘. ’ Dept. of Dermatology, 1’Archet 11, Nice, France, ‘Dept. of Dermatology, Wales Medical College, Card@ Wales, UK
H6pital University
de of
Tazarotene is a novel topical retinoid that is effective in the treatment of mild to moderate plaque psoriasis. Tazarotene is selective for retinoic acid receptor (RAR)y, the major RAR subtype in the skin, and RAR,!?, and modulates three key pathogenic factors in psoriasis. The pharmacologic selectivity of Tazarotene, combined with topical delivery and favourable pharmacokinetic profile, result in efficacy in the treatment of plaque psoriasis and an acceptable tolerability profile. Clinical studies also show that the beneficial effects of Tazarotene gel are sustained for up to 3 months after treatment cessation in some patients. Recent data show that the effectiveness of Tazarotene can be further improved by its use in combination with topical corticosteroids. The efficacy of Tazarotene in scalp, palmar/plantar and nail psoriasis, and in combination with phototherapy is currently being investigated in ongoing clinical studies. Future generations of retinoids may provide candidates for use in other dermatological diseases and in different therapeutic areas such as oncology.
Symposia
ST007 Face to face with a new acne therapy Acne vulgaris is a very common disease, affecting young people in a vulnerable stage of their life. It is a chronic inflammatory disease of the pilosebaceous units and has a multifactorial origin. A new product has been developed that combines an antibiotic (clindamycin) and a comedolytic (tretinoin) in a gel. The hypothesis that this combination will more effectively treat those forms of acne with both inflamed and non-inflamed lesions was tested in various clinical and preclinical studies, which will be presented in the satellite symposium. In several studies using inhibition of cytokine release as indicator of anti-inflammatory activity it was assessed that tretinoin possesses both anti-inflammatory and immunomodulatory properties. Combined with clindamycin in a single vehicle, these properties of tretinoin were not negatively influenced by the presence of clindamycin. The additional antibiotic effect is expected to contribute to the multi-approach treatment of acne. The influence of tretinoin and clindamycin on each other’s absorption was also investigated. It was shown in volunteers and in acne patients that the percutaneous uptake of clindamycin was not enhanced by tretinoin, and that the transdermal uptake of tretinoin was not influenced by clindamycin. Several clinical studies were performed to determine the clinical efficacy of the clindamycin and tretinoin gel. The contribution of each ingredient to the efficacy of the product was checked and the gel was compared to other anti-acne products. The results of these studies will be presented in the symposium.
ST008 Male androgenetic alopecia: A new treatment paradigm Rodney Dawber. Dept. of Dermatology, Oxford,
ST006 The compliance of science A.Y. Finlay. Dept. of Dermatology, of Medicine,
Card@
Wales,
University
of Wales
College
UK
Treatments fail if they are not used! The art of good medicine lies in effective communication, good drugs and appropriate use. This symposium focuses on solutions to problems of compliance. The heart of therapy in atopic dermatitis is the optimal use of emollients; apparently simple, but involving complicated issues of patient education, motivation and affordability. There are special challenges in helping the adolescent and young adult with persisting acne. A structured management programme to guide the patient with mild to moderate acne and advice about adjunctive therapy for those severely affected will be presented. Sunscreens fail completely with incorrect use. Some new sunscreens are far more protective than older products. The hazards and benefits of their long term application will be highlighted. This symposium is a must for all practising clinicians who wish to update their therapeutic strategies in these areas.
Churchill
Hospital,
UK
The causes of non-scarring alopecia include androgenetic alopecia, diffuse alopecia, alopecia areata, trichotillomania, etc. Presentation features, aids to diagnosis and investigative methods of these and other common causes of alopecia will be discussed. An understanding of the science of hair growth cycles is essential to correctly diagnose and treat androgenetic alopecia. The systemic and local factors which affect hair growth cycles, specifically the effect of androgens on the hair growth cycles at various body sites will also be discussed. The enzyme So-reductase and its end product, dihydrotestosterone (DHT) have been implicated in the pathogenesis of androgenetic alopecia which affects approximately 50% of the male population by age 40. Finasteride, an inhibitor of the Type 11 isoform of this enzyme, has recently been evaluated in clinical studies for the treatment of men with this disorder. Results of these clinical trials will be presented.
Satellite Symposia
ST001 Neurones and the skin - Future of neuro-dermato-cosmetology Tore110 M. Lotti. Dept.
of Dermosciences,
University
highlight the clinical relevance of Daivonex in these circumstances. of Siena,
Italy
Neurones in the skin release an heterogeneous group of molecules which is termed ‘Neuropeptides’ (NP). They act as neuromodulators, neurotransmitters, neurohormones and hormones and are both transported in the skin by nerve fibres or immune cells and locally synthesized (i.e. in keratinocytes, endotbelial cells, fibroblasts, melanocytes, Merkel cells etc.). It is easy to foretell that in the coming years the dermatologist and the cosmetologist will have to face an enormous amount of new basic information and related or suggested clinical applications of NP, agonists and antagonists. The therapeutic potentials of NP are exciting. Up to now several drugs are able to antagonise the effects of NP in the skin (i.e. capsaicin, peptide T etc.) or to exert some agonistic activities i.e. (Y-MSH, ACE-inhibitors, CGRP, Somatostatin) or to perform strong competitive inhibitory activity (i.e. Spantide). Many common skin conditions (i.e. psoriasis, allergic contact dermatitis, vitiligo, atopic dermatitis, sensitive skin, post-herpetic neuralgia, notalgia paresthetica, vulvodynia, pruritis aquagenicus etc.) will be probably successfully treated with NP, their agonists or their competitive inhibitors in the near future. Reference [I] Lotti T., Hautmann G., Panconesi E., Neuropeptides in skin, J Am Acad Dermatol 1995: 33: 482-496
ST002 Psoriasis - Therapeutic dilemma and solutions G.M. Murphy ’ , E. HGlzle *. ’ Dept.of Hospital, Dublin, Ireland, Oldenburg, Germany
*Stiidtische
Dermatology, Beaumont Kliniken Oldenburg,
Chairmen’s overview Psoriasis is a common disorder which at times poses complex management problems. Life-threatening erythrodermic or pustular psoriasis requires a variety of different therapeutic strategies dependent on the circumstances of the patient and the phase of the disease. Management of psoriasis may differ in pregnancy and childhood, and certain sites, such as face, flexures and scalp, require special therapeutic regimes. Non-compliance is an important reason for treatment failure in the management of psoriasis and disease fluctuation requires appropriate adjustment of treatment. This satellite symposium will delineate relevant effective therapeutic strategies for the various categories of psoriasis and
( ST003 ( Bacteria and the skin - Clinical practice and therapy update Kristian The&up-Pedersen. Marselisborg D., Denmark
Hospital,
Department of Dermatology, University of Aarhus, DK-8000,
Aarhus
We know that bacteriae are part of the normal skin flora. They seem to be nicely controlled by our skin lipids, our phagocytic cell system and our immune system. Actually, the greatest achievements within medicine have been the introduction of vaccines, whereby bacterial products are used to augment our defence systems. So - why bother about the skin flora ? We are only concerned, if the bacteriae give rise to boils, erysipelas, echtyma or other forms of ‘infection’. Skin infection is the clinical sign of our phagocytic cell system’s fight against aggressive and large amounts of bacteria. They are rather easily controlled by proper topical or systemic antibacterial therapy. However - the interplay between skin bacteriae and the immune system of patients with chronic inflammatory diseases seems to need more attention by dermatologists. The symposium will focus on important aspects and new observations of how bacteria can augment skin inflammation besides being causes for skin infections.
ST004 Genital warts: A recurring problem lmiquimod a new approach to treatment R.D. Maw. Royal
Victoria
Hospital,
Belfast,
Northern
Ireland
Anogenital warts have become one of the most common sexually transmitted diseases reported in the Western World. The frustration of treatment for both patient and carer is well recognised. Currently available methods rely principally on ablation of visible lesions, with often hospital-based treatments requiring multiple outpatient attendances. The failure rate, recurrence rate and side-effects of these treatments are totally unsatisfactory. Imiquimod represents the most interesting and innovative approach to therapy to become available in many years (recently launched in the US under the brand name Aldara’” cream). As it is an immune response modifier, this symposium addresses the vital issues of the immune based response to HPV infection, and the problems of persistence caused by HPV disease. The mechanisms by which Imiquimod can induce an inflammatory and cell-mediated response will be discussed, and the consequent clinical results show great cause for optimism for this treatment.
s114
Satellite
As a home-based effective treatment with a low recurrence rate we trust you will share our enthusiasm. We are sure that this symposium will be an excellent vehicle to share your thoughts and experiences of the treatment of genital HPV infections and to discuss the place for Imiquimod in clinical practice. A session not to be missed!
ST005 Tazarotene: A new topical receptorselective retinoid J.-P. Ortonne ’ , R. Marks ‘. ’ Dept. of Dermatology, 1’Archet 11, Nice, France, ‘Dept. of Dermatology, Wales Medical College, Card@ Wales, UK
H6pital University
de of
Tazarotene is a novel topical retinoid that is effective in the treatment of mild to moderate plaque psoriasis. Tazarotene is selective for retinoic acid receptor (RAR)y, the major RAR subtype in the skin, and RAR,!?, and modulates three key pathogenic factors in psoriasis. The pharmacologic selectivity of Tazarotene, combined with topical delivery and favourable pharmacokinetic profile, result in efficacy in the treatment of plaque psoriasis and an acceptable tolerability profile. Clinical studies also show that the beneficial effects of Tazarotene gel are sustained for up to 3 months after treatment cessation in some patients. Recent data show that the effectiveness of Tazarotene can be further improved by its use in combination with topical corticosteroids. The efficacy of Tazarotene in scalp, palmar/plantar and nail psoriasis, and in combination with phototherapy is currently being investigated in ongoing clinical studies. Future generations of retinoids may provide candidates for use in other dermatological diseases and in different therapeutic areas such as oncology.
Symposia
ST007 Face to face with a new acne therapy Acne vulgaris is a very common disease, affecting young people in a vulnerable stage of their life. It is a chronic inflammatory disease of the pilosebaceous units and has a multifactorial origin. A new product has been developed that combines an antibiotic (clindamycin) and a comedolytic (tretinoin) in a gel. The hypothesis that this combination will more effectively treat those forms of acne with both inflamed and non-inflamed lesions was tested in various clinical and preclinical studies, which will be presented in the satellite symposium. In several studies using inhibition of cytokine release as indicator of anti-inflammatory activity it was assessed that tretinoin possesses both anti-inflammatory and immunomodulatory properties. Combined with clindamycin in a single vehicle, these properties of tretinoin were not negatively influenced by the presence of clindamycin. The additional antibiotic effect is expected to contribute to the multi-approach treatment of acne. The influence of tretinoin and clindamycin on each other’s absorption was also investigated. It was shown in volunteers and in acne patients that the percutaneous uptake of clindamycin was not enhanced by tretinoin, and that the transdermal uptake of tretinoin was not influenced by clindamycin. Several clinical studies were performed to determine the clinical efficacy of the clindamycin and tretinoin gel. The contribution of each ingredient to the efficacy of the product was checked and the gel was compared to other anti-acne products. The results of these studies will be presented in the symposium.
ST008 Male androgenetic alopecia: A new treatment paradigm Rodney Dawber. Dept. of Dermatology, Oxford,
ST006 The compliance of science A.Y. Finlay. Dept. of Dermatology, of Medicine,
Card@
Wales,
University
of Wales
College
UK
Treatments fail if they are not used! The art of good medicine lies in effective communication, good drugs and appropriate use. This symposium focuses on solutions to problems of compliance. The heart of therapy in atopic dermatitis is the optimal use of emollients; apparently simple, but involving complicated issues of patient education, motivation and affordability. There are special challenges in helping the adolescent and young adult with persisting acne. A structured management programme to guide the patient with mild to moderate acne and advice about adjunctive therapy for those severely affected will be presented. Sunscreens fail completely with incorrect use. Some new sunscreens are far more protective than older products. The hazards and benefits of their long term application will be highlighted. This symposium is a must for all practising clinicians who wish to update their therapeutic strategies in these areas.
Churchill
Hospital,
UK
The causes of non-scarring alopecia include androgenetic alopecia, diffuse alopecia, alopecia areata, trichotillomania, etc. Presentation features, aids to diagnosis and investigative methods of these and other common causes of alopecia will be discussed. An understanding of the science of hair growth cycles is essential to correctly diagnose and treat androgenetic alopecia. The systemic and local factors which affect hair growth cycles, specifically the effect of androgens on the hair growth cycles at various body sites will also be discussed. The enzyme So-reductase and its end product, dihydrotestosterone (DHT) have been implicated in the pathogenesis of androgenetic alopecia which affects approximately 50% of the male population by age 40. Finasteride, an inhibitor of the Type 11 isoform of this enzyme, has recently been evaluated in clinical studies for the treatment of men with this disorder. Results of these clinical trials will be presented.