8th Clinical Dermatology Congress August 24-25, 2016 Sao Paulo, Brazil

Jonathan Kentley received his Medical degree in 2014 from Barts and the London School of Medicine and Dentistry. Throughout his foundation training in London he has publised several papers and worked on a number of quality improvement projects in both dermatology and medicine.

Skin cancer is on the rise and accounts for a large burden of the dermatologist’s workload. Wide local excision (WLE) may be necessary after incisional biopsy in order to ensure complete removal of the primary lesion and minimize local recurrence of tumours with metastatic potential, most commonly melanoma and squamous cell carcinoma (SCC)(1). At present there are no guidelines on when this re-excision should take place.rn Although there is no evidence to suggest that delayed excision has an impact on survival, the psychological impact of a skin cancer diagnosis on the patient cannot be underestimated(2). Many patients report being distressed by anxiety after diagnosis and 70% of these patients do not feel that doctors adequately addressed their concerns(3, 4). rn At our institution we performed 42 WLEs between September and December 2015. Only 21 of these were performed within 6 weeks of the histology from excisional biopsy being available. We surveyed 14 patients who had been diagnosed with skin cancer and 8 felt that WLE should be done within 6 weeks. 5 wanted the procedure done at the first available slot. Patients appeared to trust the decisions made by their dermatologists. rn Diagnosis with skin cancer is a stressful time for patients and delays in re-excision are likely to exacerbate patient anxiety. Management may impact significantly on surgical capacity in a dermatology department and needs to be planned for. Patients should be well informed and encouraged to voice their concerns. WLE should ideally take place within 6 weeks. rn

Jose Manuel da Costa Mesquita Guimaraes was graduated with distinction from Faculty of Medicine of Porto, in 1961 and is a Specialist of Dermatology and Venereology since 1968. He has completed his PhD with the thesis “Citologia da secreção holócrina”, in 1975. He is the Professor of Dermatology and Venereology of the Faculty of Medicine of Porto since 1977, wrote 282 works alone and in collaboration and in 1983 published a book entitled \"Dermatologia Parasitária e Infecciosa-Venereologia\". He was the Head of the Department of Dermatology and Venereology of Hospital de São João in Porto for 20 years, President of College of Specialty of Dermato-venereology of Order of Physicians of Portugal and Chairman of the Supervisory Board of the Portuguese Society of Dermatology and Venereology for 6 and 5 years, respectively.

With atopic dermatitis I have observed with high frequency, gastritis, enteritis, colitis, irritable bowel syndrome, intestinal dysbacteriosis, constipation and food allergies, besides the already known allergic rhinitis/rhinoconjunctivitis and asthma. The patients itch, scratch themselves and perpetuate the injury in elective characteristic areas of atopic dermatitis. The control of the itching and the inflammations is fundamental. Guidelines about the treatment of atopic dermatitis have recently been published. I have particular attention not to do external interventions causing alterations of the cutaneous film, microflora destruction, atrophy, xerosis and addiction. The cutaneous film has an extremely complex physical-chemical composition and it has no equivalent in the market. About the skin microflora it is common knowledge that it is inseparable from the normal skin morphophysiology and its homeostasis. Sedating and non-sedating antihistamines and oral corticosteroids, in particular these latter, are effective in itching and inflammation control. Moreover oral corticosteroids are also extremely effective in the treatment of systemic inflammations and with proper use never produced rebound lesion or any serious adverse effects. Finally, the patients have high quality of life and are well-controlled if they follow suitable topic and systemic treatment, multidisciplinary, appropriate to each case, in particular the itching, multi-inflammations and allergies.

Marcelle Silva de Abreu is currently a PhD student at the University of Barcelona, Faculty of Pharmacy. She has a Master’s degree in Research, Development and Control of the Drugs. Her research is centered in the field of Nanoscience and Nanotechnology in the area of nanostructured drug delivery systems.\r\n\r\n

Pioglitazone (PGZ) is an agonist of peroxisome proliferator-activated receptors (PPARs) from the nuclear receptor superfamily that regulate lipid, glucose and amino acid metabolism. More recently, PPARs and corresponding ligands have been shown in skin and other organs to regulate important cellular functions, including cell proliferation and differentiation, as well as inflammatory responses. The main goal of this work was the association of PGZ to poly (D, L-lactide-co-glycolide) polyethylene glycol (PLGA-PEG) nanospheres (NSs), for the treatment of skin disorders. NSs of PGZ were prepared by the solvent displacement technique using Tween-80 as surfactant, a matrix of PLGA-PEG and acetone as organic solvent. In order to determine the influence of several factors such as: The pH of the aqueous phase, the initial concentration of the stabilizer and polymer concentration on the physicochemical properties (particle size, polydispersity index (PI), zeta potential (ZP)) of NSs a factorial design has been carried out. Ex vivo permeation experiments were realized in Franz diffusion cells using human skin. PGZ-NSs and free drug with different promoters (to potentiate or accelerate the absorption through biological barriers) have been assayed. Samples of 300 µl was withdrawn at selected time intervals for 31 hours and replaced with the same volume of fresh receptor medium (Transcutol and PBS solution). At the end of the study, the skin was used to determine the amount of drug retained. Further studies concerning new pharmacological indications of this drug could be developed in order to possible application for the treatment of various skin diseases.