Dermatology Conference 2018 Programme Book

Final Programme

30 August - 2 September 2018 Durban ICC, South Africa

Content Index

2

Welcome Messages

3-6

General Information

8

Speaker Biographies

10

Programme 16 Oral Abstracts 33 Exhibition Floorplan

68

Exhibitors Key 69 Sponsors 71

LOC Members Ncoza Dlova, Anisa Mosam, Percy Naidu, Sian Hartshorne, Noufal Raboobee, Nokubonga Khoza, Kiasha Govender, Khanyi Dladla, Ayesha Akinkugbe, Evanson N. Kamuri, Izolda Heydenrych.

Welcome Message

3

Welcome to “Dermatology for Africa� Congress 2018 Dear Colleagues The 71st Annual Congress of the Dermatology Society of South Africa will be held in conjunction with the 2nd African Society of Dermatology and Venereology (ASDV) congress.

For the first time in South Africa, we will be sharing the latest trends and research in dermatology with colleagues from Africa and beyond. We have interest and support from colleagues in the USA, UK and Europe. The mandate of the combined meeting is to advance the specialty of dermatology in Africa, promote the highest standards of clinical practice, disease control programs, collaborative research and influence policy development in the African region.

There is an exciting social programme with day tours, pre and post congress safaris and visits to traditional Zulu villages which can be arranged through the conference organisers. We expect more than 50 exhibitors to attend.

We welcome delegates from Africa and the rest of the world to this meeting, which will be held on Durban’s Golden mile, a melting pot of cultures, on the east coast of South Africa. Practical treatments and updates of skin diseases relevant in daily practice will be highlighted: infectious diseases, community dermatology, paediatric dermatology, dermatological surgery, eczema, skin cancers and aesthetics.

We look forward to hosting you in Durban, the coolest and sunniest place in SA.

Prof Ncoza Dlova Congress President

Prof Anisa Mosam Chair Scientific Committee

Welcome Message

4

Welcome from the President of ASDV Dear Distinguished guests, Executive Committee, Conference Organizers, Colleagues, Ladies and Gentlemen.

It’s with immense pleasure, honour and humility that I take this opportunity to welcome you all to Durban, South Africa and to the second African society of Dermatology and Venerology conference. I take this opportunity also to thank the organizing committee for the wonderful job they have done to make this conference a success. We envision a conference rich in scientific content encompassing the latest advances, information and innovations in the fields of Dermatology, Venerology, Aesthetics and Dermatosurgery.

The theme of this year’s conference is “Dermatology for Africa”. In line with the theme we gear to discuss problems that affect us and the accepted good practices. The aim is to impact knowledge in such a way that each delegate can put it into their practice and make Africa a better place.

We have invited renowned world and regional experts who will be sharing the latest discoveries and development as well as practice pearls in the field of Dermatology and Venerology. I urge members and participants to interact maximally as well as enjoy the beautiful city of Durban; a cosmopolitan city which is a tourists dream come true. It is a bustling cosmopolitan city with its unique natures and a vibrant multi-cultural society where modern meets the tradition.

I therefore take this opportunity once again to thank and wish all a nice stay in Durban as we enhance the theme of this year’s conference. “Dermatology for Africa”.

Dr. Evanson N. Kamuri President: ASDV

Welcome Message

5

Welcome from the President of the SASDS Dearest Colleagues “Education is the most powerful weapon which you can use to change the world.”

- Nelson Mandela Our great statesman often alluded to the power of education and how the sharing of it grants the permission to shine - to recipient and teacher alike.

This year’s “Dermatology for Africa” embodies the Unity in Dermatology theme which has woven a golden thread throughout this past year. We now have a new United in Dermatology website, a homepage that embraces all our societies and a combined educational platform in evolution. It thus seems fitting that this year of exponential growth should culminate in a congress embracing our entire continent.

We would also like to use this meeting as a springboard for a new inclusive initiative around African Beauty.

Our heartfelt gratitude to the international invited SASDS speakers who are illuminating our programme:

In alignment with our SASDS mission statement of “Taking stewardship of South African Procedural Dermatology, nurturing safe procedural practice and striving to be gatekeepers of excellence“ the SASDS is again offering accredited Certification courses in conjunction with Stellenbosch University. Practical Aesthetics for the Dermatologist will be presented

by Dr. Sian Hartshorne on 30th August, whilst the full day practical Toxins course, presented by Dr. Izolda Heydenrych, is scheduled for 25th August in Cape Town.

The dedicated surgical courses will be run in the latter part of the year.

May this congress be memorable, may it be meaningful and may we, collectively, change the skin of the world around us.

We anticipate a bright meeting of minds!

Dr. Glenn Goldman who will be sharing invaluable insights into the surgical management of melanoma and nonmelanoma skin cancer, topics supremely relevant to our sunny climate.

Dr. Vandana Chatrath who will be elucidating on wide-ranging topics such as the treatment of facial melanosis and management updates for the metabolic syndrome.

Dr. Marva Safa Diana who will be addressing current generational and controversial facets of aesthetics.

Izolda Heydenrych President: South African Society for Dermatologic Surgery

Welcome Message

6

Welcome from the President of the Vitiligo Society of South Africa The Vitiligo Society of South Africa (VSSA) extends a warm welcome to all delegates of this very significant 2018 combined congress.

Vitiligo is a particular problem in the African continent, with prominent contrast between normal and involved skin, yet treatment options in Africa remain severely limited. We are optimistic that the treatments discussed during the congress will benefit the entire continent and beyond.

Since its inception, the VSSA has introduced new treatments for vitiligo each year. This year is no exception, with hair follicle grafting rising to the occasion.

We have an exciting line up of 3 well-known international vitiligo surgeons, Dr. Davinder Parsad from the Post Graduate Institute of Medical Research in Chandigarh, Dr. Somesh Gupta from the All India Institute of Medical Sciences in Delhi and Dr. Nilesh Goyal, hair transplant surgeon from Mumbai. Together they will perform live demonstrations of all the popular surgical techniques currently available for vitiligo. These include non-cultured melanocyte grafting, preparation of a cell suspension inside suction blisters and transplantation of intact hair follicles into vitiligo areas. These useful techniques can be applied equally to other situations requiring repigmentation eg surgical scars.

There will be a panel discussion around live patients on difficult-to-treat areas and recent advances in vitiligo will be addressed.

We hope to see you at the pre-congress vitiligo symposium and during the talks that follow, and of course, please take a moment to imbibe the sights and sounds of Durban.

Noufal Raboobee President: Vitiligo Society of South Africa

General Information

8

Registration and Speaker Preparation

Social Functions

Thursday, 30 August 16:00 – 19:00 Friday, 31 August 06:30 – 17:00 Saturday, 1 September 07:00 – 18:00 Sunday, 2 September 07:00 – 12:00

Opening and Welcome Cocktail Evening Date: Thursday, 30 August 2018 Time: 18:00 Venue: Exhibition Hall

CPD Accreditation

Congress Gala Dinner Date: Saturday, 1 September 2018 Time: 18:30 for 19:00 Venue: Café La Plage, Umhlanga Dress: “A night out in Africa – Wear your tribe”

Discovery CPD Desk: delegate attendance will be logged electronically utilising a bar coding system and handheld scanners.

Kindly ensure that your badge is scanned twice daily for maximum CPD attendance at both the morning and afternoon tea sessions.

Please note that all ethics sessions will be scanned separately.

Delegates will receive an email after the congress providing instructions and a link to download your CPD certificate.

Please ensure your email details are correct by visiting the MYCPD desk. No hard copy certificates will be available at the congress.

Wi-Fi Wireless network: Durban ICC Wi–Fi Password: Convention1 Medical Emergencies A medic will be available onsite for any medical emergencies, please contact the registration desk for assistance.

Smoking Policy The Durban ICC is a smoke-free building.

Smoking is only allowed in the courtyards and on the coffee-shop terrace.

Parking Collect your exit parking ticket at the registration desk.

Shuttle Transport There will be scheduled transport offered between appointed hotels and the Durban ICC for the duration of the event.

Airport Transfers Please visit the Registration Desk for any transport related queries or to book your departure airport transfer.

Invited Speaker Biographies

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DSSA Invited Speakers Prof Jean Bolognia, MD, is Professor of Dermatology at the Yale University School of Medicine. She has served as President of the Medical Dermatology Society, the Women’s Dermatologic Society and the American Dermatological Association, in addition to serving as Vice-President of the Society of Investigative Dermatology, the American Board of Dermatology, and the International Society of Dermatology. She has also been elected to serve on the Board of Directors of the American Academy of Dermatology and the International League of Dermatological Societies and is currently Secretary-General of the latter organization. Jean is the senior editor of the textbook Dermatology, which is now in its fourth edition, and Dermatology Essentials. She is also the co-founder of the Clinical Scholars program of the SID and author of over 200 articles and book chapters.

Dr. Chrysalyne Schmults is a graduate of Yale College and Yale School of Medicine and performed her residency at NYU. She is Associate Professor of Dermatology at Harvard Medical School. She was part of the faculty of the University of Pennsylvania for 4 years before becoming Director of the Brigham and Women’s Hospital (BWH) Mohs and Dermatologic Surgery Center in 2007. In 2008, she founded the BWH High-Risk Skin Cancer Clinic which cares for patients with multiple skin cancers, severe sun damage, or tumors at high risk for recurrence. It has become a referral center for patients with locally advanced and metastatic basal and squamous cell carcinoma (BCC and SCC, respectively) in need of advanced multidisciplinary care and clinical trials. The clinic is one of only a handful world-wide that is dedicated to this patient population.

Dr. Schmults has developed new staging systems for SCC and BCC which for the first time identified the subset of patients in need of studies of staging and adjuvant treatment. She was a member of the AJCC 8th edition SCC task force which was informed by her BWH SCC staging system and is the editor of the first textbook on high-risk SCC. In 2012, Dr. Schmults launched a unique 2-year ACGMEaccredited Micrographic Surgery and Dermatologic Oncology fellowship program which integrates a MPH degree into the curriculum to combat the shortage of dermatologic surgeons trained in clinical research methodology.

Graduates have attained faculty positions at high caliber academic centers and are actively engaged in research. Together with Dr. Ncoza Dlova and Dr. Vishal Patel, Dr. Schmults lead a 4-year project to train dermatology residents and faculty in

Invited Speaker Biographies

11

dermatologic surgery at Kwa-Zulu Natal University, Durban, South Africa. Modeled after American College of Graduate Medical Education training, the program may serve as a model for establishment of dermatologic surgical training at universities where such training is not available.

Dr. Schmults has served on the board of directors of the American College of Mohs Surgeons and the International Society for Dermatologic Surgery, and as president of the International Immunology and Transplant Skin Cancer Collaborative.

She lives in Boston with her husband and two daughters.

Dr. Rannakoe Lehloenya is a Dermatologist and an Associate Professor of Medicine at the University of Cape Town and Groote Schuur Hospital. His main research interest is cutaneous adverse drug reactions, a subject on which he has published extensively. He is currently involved in multiple local and international studies on the subject. His other significant interest is anthropology of human attractiveness, a subject on which he is currently writing a book.

SASDS Invited Speakers Dr. Glenn Goldman is the chief of dermatology at the University of Vermont College of Medicine. Dr. Goldman grew up in southeastern Connecticut. He was graduated from Dartmouth College and Cornell Medical School. He did his internship at The New York Hospital – Memorial Sloan Kettering Cancer Center and completed his dermatology residency at Yale University. This was followed by a one year fellowship in Mohs surgery and reconstruction with Leonard Dzubow at the University of Pennsylvania.

Since 1996 Dr. Goldman has been on faculty at the University of Vermont College of Medicine. Since joining the faculty he established and grew both the dermatology residency and procedural dermatology fellowships. He is a full professor of medicine and also has an appointment in the department of surgery. He has 46 refereed publications, 12 book chapters and reviews, and he has authored a text of facial reconstruction.

He has given 223 lectures locally, regionally, nationally and internationally. He is an internationally recognized dermatologist and has travelled to numerous countries to teach dermatologic surgery. He is currently on the Board of Directors

Invited Speaker Biographies

12

of the American Society for Dermatologic Surgery and serves as the Chair of the International Travelling Mentorship Program. In this role he has travelled to Chile, Romania, and South Africa to operate on patients and further the ability of local dermatologic surgeons. He is Secretary Treasurer of the American College of Mohs Surgery.

Dr. Goldman’s greatest interests lie in the areas of tumor removal and reconstruction.

He has served in many positions including being on the Board of Trustees of the American College of Mohs Surgery (ACMS) and a five year tenure as the ACMS representative to the American Medical Association Resource Based Relative Value Update Committee. He is currently on the Board of Trustees of the American Society for Dermatologic Surgery. Dr. Goldman has received numerous awards and honors, but his greatest achievement has been in the training of his residents and fellows, several of whom have gone on to distinguished academic careers.

When is not operating he will be found fishing or travelling with his boys, or a combination of the two.

Dr. Marva Safa Diana is an internist and anti-aging specialist with 22 years of experience and 15 years in the field of aesthetic medicine.

She was trained in the USA for cosmetic dermatology and is a member of the Amercican Academy of Anti-Aging Medicine. Her area of specialization is in toxin and filler injectables in the face as well as skin treatments with peelings and lasers. She is also very active in body contouring treatments. Dr. Safa has been a trainer and an expert in the field of cosmetic dermatology and has been a global trainer since 2007.

She is a senior faculty member of the Allergan Medical Institute and actively involved with different clinical trials as well as trainings for physicians around the world. Dr. Safa opened her own private clinic in 2004 in Switzerland, catering to the needs of her patients in the field of injectables, peelings, lasers, body contouring treatments as well as prevention and anti-aging medicine. She is passionate about women’s health and is actively involved in the holistic approach to treatment of peri-menopausal and menopausal women.

Invited Speaker Biographies

13

Dr. Vandana Chatrath is a graduate from Lady Hardinge Medical College, New Delhi, India and has done her dermatology training from Boston University. She has also done her fellowship in dermatologic surgery, lasers and cosmetic procedures like Botox, fillers from Boston University. She has been in private practice in Delhi as part of Delhi Dermatology Group since the past 14 years. She has published many papers in eminent journals and written a chapter for a pediatric and Cosmetology textbook and World Clinics issue on Acne. She has lectured on topics pertaining to clinical as well as procedural dermatology in many national and international conferences. Her special areas of interest include pigmentary disorders and facial Aesthetics in Asians.

VSSA Invited Speakers Dr. Somesh Gupta is Professor of Dermatology & Venereology at All India Institute of Medical Sciences, New Delhi, India. He has approximately 200 papers published in indexed journals and few books, including one edited international book on Medical and Surgical Management of Vitiligo, published by Wiley Blackwell, Oxford. He has introduced some new and simplified techniques of transplantation in vitiligo and other areas of Dermatologic Surgery.

He is past president, and secretary of Association of Cutaneous Surgeons of India and past editor of Journal of Cutaneous and Aesthetic Surgery.

Dr. Nilesh N. Goyal is a cosmetic dermatologist practicing in the vibrant city of Mumbai, India from his clinic, Juvenis and as a Consultant at Lilavati Hospital and Bombay Hospital. He has gained many surgical skills during training across the globe. He has special interests in Liposuction and Fat Transfer for Dermatologic and Cosmetic indications. He also specializes in Hairfall management and Hair transplant surgery. He has invented the Triple Combination Injection method for resolution of keloids and hypertrophic scars. He has received the “Outstanding Contribution to Dermatosurgery� award by International Travelling Mentorship Program of Prof Lawrence Field in 2017. He firmly believes in finding newer and effective cosmetically appealing solutions for sequelae of dermatologic conditions.

Invited Speaker Biographies

14

Davinder Parsad, MD, is currently working as Professor at Postgraduate Institute of Medical Education & Research, Chandigarh and Hony Professor at University “G� Marconi, Italy. His main area of research is vitiligo - pathogenesis and treatment both medical and surgical.

He chaired/co-chaired, presented invited/guest lectures, papers at more than 100 International conferences/meetings. Received many travel award and fellowships (Fujita Health University, Nagoya, St George Hospital UK, Wake forest University, Winston-Salem, North Carolina, USA and Bordeaux, France.

He received the prestigious Ambady Oration of IADVL. Founder secretary of Asian Society for Pigment cell Research (ASPCR) and President of ASPCR (2011-2014).

He is the president of Indian Association of Dermatologists, Venereologists and Leprologists (Punjab, Chandigarh and HP)-2014.

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08:00 – Registration 09:30 VSSA Full Day Workshop 08:00 – Live video-conferencing of punch grafts, hair transplantation 16:00 Venue: Inkosi Albert Luthuli Central Hospital, Radiology Seminar Room Facilitators: Jonathan Smith, Dagmar Whitaker 08:00 – Opening 08:05 Noufal Raboobee, South Africa 08:05 – Creation of suction blisters 09:00 Somesh Gupta, India 09:00 – Taking of thin grafts, trypsination for 1 hour 10:00 Davinder Parsad, India 10:00 – Tea/Coffee Break 10:30 10:30 – Centrifugation of cellular graft 11:00 Davinder Parsad, India 11:00 – Transfer of graft to recipient Vitiligo site 11:30 Davinder Parsad, India 11:30 – Injection of trypsin into suction blisters 12:00 Somesh Gupta, India 12:00 – Transfer of hair follicles to Vitiligo sites 13:00 Nilesh Goyal, India 13:00 – Lunch Break 14:00 14:00 – Preparation of cellular graft from blisters 15:00 Somesh Gupta, India 15:00 – Excimer laser and light 15:10 Jonathan Smith, South Africa

Pre-Congress Workshops and Opening of Congress

Programme - Thursday, 30 August 2018 16

13:00 – 14:00 14:00 – 14:30 14:30 – 15:00 15:00 – 15:30 15:30 – 16:00

10:00 – 10:05 10:05 – 11:00 11:00 – 12:00 12:00 – 12:30 12:30 – 13:30

15:10 – 15:20 15:20 – 16:00 10:00 – 18:00

Tea/Coffee Break

Session 2 Facilitators: Molikane Masenya & Laduma Ngwanya Immunohistochemistry: Principles & diagnostic applications in routine dermatopathology Wayne Grayson, South Africa Immunofluorescence studies: Basic principles & diagnostic applications Tirelo Pitjadi, South Africa Electron microscopy in skin pathology: How, why & is it still relevant?

Wayne Grayson, South Africa Principles of PCR & the diagnostic applications thereof in dermatopathology Johann Schneider, South Africa

Lunch Break

Excimer light demonstration Noufal Raboobee, South Africa Treating challenging sites in Vitiligo: Panel Discussion Davinder Parsad, India; Somesh Gupta, India; Nilesh Goyal, India DSSA Workshop: Dermatopathology Workshop Venue: Durban ICC, MR 21DEFG Session 1 Facilitators: Wayne Grayson Welcome Wayne Grayson, South Africa The skin biopsy & its passage from the patient to a final histopathology report Molikane Masenya, South Africa Dermatopathology: A diagnostic approach based on the important histological reaction patterns Faffa Jordaan, South Africa Histochemical stains & their diagnostic applications in dermatopathology Tirelo Pitjadi, South Africa

Programme - Thursday, 30 August 2018 17

09:30 – 09:40 09:40 – 10:00 10:00 – 10:30 10:30 – 11:00 11:00 – 11:30 11:30 – 12:30 12:30 – 13:00 13:00 – 13:15

09:30 – 17:00

16:30 – 17:40 16:00 – 16:30 16:30 – 17:00 17:00 – 17:30 17:30 – 17:40

18

Glycolic Acid Peels: Panel Discussion

Practical Peel Session: Four live demonstrations

Introduction to glycolic acid peels Nomphelo Gantsho, South Africa

Lunch Break

Tea/Coffee Break

Session 3 Facilitators: Tirelo Pitjadi An approach to the diagnosis of common skin adnexal tumors Wayne Grayson, South Africa A basic approach to the diagnosis melanocytic proliferations Johann Schneider, South Africa Hair follicle microanatomy & its diagnostic relevance in the evaluation of scalp biopsies for alopecia Laduma Ngwanya, South Africa Thank you and closing remarks Wayne Grayson, South Africa SASDS Workshop: Practical Aesthetics for the Dermatologist: Optimising the use of Cosmetics, Glycolic Acid Peels and the use of Microneedling Venue: Durban ICC, MR 21ABC Facilitators: Sian Hartshorne, Nokubonga Khoza, Nomphelo Gantsho Introduction to Workshop Sian Hartshorne, South Africa Cosmetic Products: Where do we begin?

Sian Hartshorne, South Africa Cosmetic Products: Interpreting ingredients in cosmetic products Sian Hartshorne, South Africa

Programme - Thursday, 30 August 2018

Tea/Coffee Break

Final Discussion and MCQ Questionnaire

Optimising the use of cosmetics and advising patients on cosmetic use Sian Hartshorne, South Africa Optimising the retail of cosmetic products in a dermatology practice Sian Hartshorne, South Africa

Microneedling Panel Discussion

Practical Microneedling Session: Live demonstration

Microneedling Nokubonga Khoza, South Africa

DSSA Workshop: Hair Disorders 09:30 – Venue: Inkosi Albert Luthuli Central Hospital, Staff Development Room 15:00 Facilitators: Ncoza Dlova 09:30 – Tea/Coffee Break 10:00 10:00 – Approach to African women with hair loss 10.20 Susan Taylor, United States of America 10:20 – Medical and cosmetic treatments for hair loss in women of colour: An update 10:50 Valerie Callender, United States of America 10:50 – CCCA cases and their management 11:10 Cheryl Burgess, United States of America 11:10 – Pseudofolliculitis barbae and acne kelodalis nuchae 11:40 Andrew Alexis, United States of America 11:40 – Hair care experiences, practices and views of African women from SA 11:55 Nokubonga Khoza, South Africa

13:15 – 14:00 14:00 – 14:45 14:45 – 15:00 15:00 – 15:30 15:30 – 16:00 16:00 – 16:15 16:15 – 17:00

Programme - Thursday, 30 August 2018 19

Tea/Coffee Break

Welcome Cocktail Evening - Exhibition Hall

Entertainment

19:00

Welcome and Opening of Congress Venue: Durban International Convention Centre, Hall 4AD Poetry recital

Hands on case examination and dermoscopy

Live patient testimonials and impact on quality of life

George Findlay Lecture: Skin and Hair Science in Africa African hair and skin science historical perspectives Michèle Verschoore, France

18:45

20

Dermoscopy of hair disorders in Nigeria Adebola Ogunbiyi, Nigeria Interesting clinical cases Ncoza Dlova, South Africa African hair diversity: from biology to hairstyles Michèle Verschoore, France and Mimmi Biggar, South Africa Panel Discussion: Meet the experts with: Michèle Verschoore, Susan Taylor, Ncoza Dlova, Valerie Callender, Adebola Ogunbiyi, Cheryl Burgess, Andrew Alexis

Lunch Break

Irritant contact dermatitis due to artificial hair extensions in atopic patients Patiswa Nombona, South Africa Treatment of Alopecia Areata Cheryl Burgess, United States of America

18:15

18:00

11:55 – 12:10 12:10 – 12:30 12:30 – 13:00 13:00 – 13:20 13:20 – 13:40 13:40 – 14:10 14:10 – 14:40 14:40 – 14:50 14:50 – 15:30 15:30 – 16:00

Programme - Thursday, 30 August 2018

Pathophysiology of joint and skin diseases and implications for 07:00 – treatment. Lessons from the joint: 07:40 therapeutic options for psoriatic arthritis in clinical practice.

Bridget Hodkinson, South Africa

Janssen Breakfast Symposium: A Practical Guide to New Treatments on Psoriatic Arthritis and Psoriasis Venue: MR 22DEFG Sponsored by Janssen

21

DSSA Parallel Session: Skin Cancers Venue: MR 22DEFG Chairpersons: Avumile Mankahla, Mahlatse Kgokolo

SASDS Parallel Session: Aesthetic Dermatology – Updates from 08:30 – around the world 10:30 Venue: Hall 4BC Chairpersons: Sian Hartshorne, Ishaan Ramkisson

Pathophysiology of the skin and implications for treatment. Lessons a powerful inhibitor of 07:40 – from the skin: therapeutic options 07:40 – Thiamidol, tyrosinase 08:20 human Ishaan Ramkisson, South Africa 08:20 for psoriasis arthritis in clinical practice.

Willie Visser, South Africa 08:20 – Questions and Answers 08:20 – Questions and Answers 08:30 08:30

07:00 – Introduction 07:05 Clinical insights: and sun 07:05 – Hyperpigmentation protection 07:40 Susan Taylor, United States of America

Eucerin Breakfast Symposium: Hyperpigmentation – Introducing a New, Safe, Efficacious and Fast Acting Treatment Molecule Venue: Hall 4AD Sponsored by Beiersdorf

DSSA Parallel Session: Medical 08:30 – Dermatology 08:30 – Hall 4AD 10:30 Venue: Chairpersons: Willie Visser, Ranks 10:30 Lehloenya

Izolda Heydenrych, South Africa Vandana Chatrath, India Marva Safa Diana, Switzerland

Registration

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

Allergan Breakfast Symposium: 07:00 – Brekkie and Brief - Beyond Beauty 08:30 Venue: Hall 4BC Sponsored by Allergan

07:00

07:00

Programme - Friday, 31 August 2018

10:30 – 11:00

skin microbiome – why it is 08:30 – Your important a healthy glow 08:45 Ilsa Orrey, for South Africa

22

beauty: How to incorporate 09:00 – Ethnic use hyaluronic acid fillers 09:15 the Ishaan Ramkisson, South Africa

Panel Discussion 10:25 – Vandana Chatrath, 10:30 Marva Safa Diana, Izolda Heydenrych

Update on causes 10:15 – Pigmentation: treatments 10:25 and Maria Vitale, Spain

on the management of 09:45 – Update Melasma 10:00 Vandana Chatrath, India 10:00 – Myomodulation in facial palsies 10:15 Izolda Heydenrych, South Africa

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

10:05 – Oral pre-cancer and cancer 10:30 Marcia Ramos-e Silva, Brazil

09:30 – Microneedling in ethnic skins 09:45 Pholile Mpofu, South Africa

in transit nodular MM 09:15 – Aesthetics treatments in 20-30-year09:35 – Metastatic Sporotrichosis old patients 09:50 mimicking Olutomidimu Afolabi, Nigeria 09:30 Marva Safa Diana, Switzerland

09:15 – Melanoma in blacks 09:35 Anaba Ehiaghe Lonia, Nigeria

aging Indian face: How to treat 08:55 – AK NMSC 08:45 – The differently 09:15 Dagmar Whitaker, South Africa 09:00 Vandana Chatrath, India

PDT in NMSC 08:30 – Daylight Wolfgang 08:55 Germany Philipp-Dormston,

The spectrum of blistering of malignancy in XP 10:10 – diseases in the Northern Zone of 09:50 – Spectrum in Tanzania 10:30 Tanzania 10:05 patients Lulyritha Kini, Tanzania Elisante John Masenga, Tanzania

The Immunocompromised district 09:20 – in dermatology 09:50 Robert Brodell, United States of America Pellagra emerging due to INH 09:50 – prophylaxis 10:10 Kelvin Mponda, Malawi

Connective tissue disease in 08:30 – Africa: An update 09:00 Chris Lovell, United Kingdom Vulval ulcers 09:00 – Claire Fuller, 09:20 United Kingdom

Programme - Friday, 31 August 2018

Icthyosis with confetti Saskya Claasens, South Africa

Disseminated giant hyperkeratotic porokeratosis Minette Swart, South Africa

23

SASDS Parallel Session: Surgical and Vitiligo Session 14:00 – Practical Hall 4BC 16:00 Venue: Chairpersons: Pieter du Plessis, Derek Odendaal, Noufal Raboobee fat transplant 14:00 – Autologous Nilesh Goyal, 14:30 Saudi Arabia India and Fatma Al Shehri, to facial reconstruction 14:30 – Approach Glenn Goldman, 15:00 United States of America

Lunch Break / Trade / Poster Viewing - Exhibition Hall

Parallel Session: Registrar Presentations 14:00 – DSSA Hall 4AD 16:00 Venue: Chairperson: Francois Jordaan

13:00 – 14:00

Presentation of ILDS award to Gail Todd by Jean Bolognia

12:40 – Dermatology in Africa: What are the needs?

13:00 Gail Todd, South Africa

12:15 – A rational approach to the treatment of facial melanoma 12:40 Glenn Goldman, United States of America

11:55 – Global health dermatology 12:15 Claire Fuller, United Kingdom

11:00 – A practical approach to disorders of hypo and hyperpigmentation (John Moche Memorial Lecture) 11:30 Jean Bolognia, United States of America dermatologic surgery training programme and Moh’s fellowship 11:30 – USA/SA Chrysalyne D. Schmults, United States of America 11:55 Sponsored by Bayer

Plenary Session 11:00 – Combined Hall 4AD 13:00 Venue: Chairpersons: Ncoza Dlova, Grace Okudo, Adebola Ogunbiyi, Glenn Goldman

Programme - Friday, 31 August 2018

15:20 – 15:40 15:40 – 15:50 15:50 – 16:00

Free Evening

24

Anatomical site closures: Temporal region Pieter du Plessis, South Africa Anatomical site closures: Nasal region Derek Odendaal, South Africa Surgical procedures of the ear Marc Roscher, South Africa

Managing squamous cell carcinomas 15:00 – Chrysalyne D. Schmults, 15:20 United States of America Sponsored by Bayer

16:00 – Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall 16:30 16:30 Combined DSSA and SASDS and ASDV AGM - Venue: Hall 4AD

A Genodermatosis with a peculiar reaction pattern Kim Ansley, South Africa Arose within the thorns Pumeza Makaula, South Africa Family ties: A familial case of tuberous sclerosis complex Mndeni Lindokuhle Kunene, South Africa When atypical is atypical: Mycobacterial infection in an immunosuppressed patient Tarryn Jacobs, South Africa Male pattern androgenetic alopecia in two post-menopausal women Lerinza Van den Worm, South Africa Intertriginous ulcers in an adult Aimee Gavin, South Africa Linear morphoea with synpolydactyly in a SA infant Nkeiruka Elsie Ezomike, South Africa Paraneoplastic scleromyxoedema with non-Hodgkins lymphoma: A rare presentation Musonda Sharon Machona, South Africa Swift’s not dead. Can you see he’s still Pink?

Jeremy David O Kennedy, South Africa Histoid Leprosy Slindile Buthelezi, South Africa

The Disney Masquerade: Talaromyces Marneffei Nerissa Moodley, South Africa

Programme - Friday, 31 August 2018

25

What’s new in depigmenting 08:30 – therapies 08:50 Valerie Callender, United States of America

procedures in black skin 08:50 – 08:50 – Cosmetic Cheryl Burgess, United States of 09:05 09:10 America

of the worlds- part 3 09:10 – War Izolda Heydenrych, 09:20 South Africa

09:00 – Mixa: Sensitive skin expert 09:10 Evanson Kamuri, Kenya

08:40 – Sensitive skin and ethnicity 09:00 Roland Jourdain, France

Lawrence Field Inaugural Lecture: rational approach to treating 08:30 – A 08:30 – Skin typology in South Africa skin cancer 08:50 non-melanoma Glenn Goldman, United States of 08:40 Poonam Sewraj, South Africa America

DSSA Parallel Session : Ethnic 08:30 – Skin Session 10:30 Venue: Hall 4AD Chairpersons: Ncoza Dlova

Imaging and treatment of aggressive tumours Alison Vidimos, Unites States of America as the first South An update on therapies 09:05 – Experience 09:10 – Melasma: African trained Mohs Micrographic Taylor, 09:30 Susan 09:15 Surgery Fellow United States of America Nivana Ramlachan, South Africa Managing hyperpigmentation: 09:30 – current and emerging therapies 09:15 – Mohs Microsurgery in Tanzania 09:50 Andrew Alexis, 09:25 Daudi Mavura, Tanzania United States of America

SASDS and VSSA Parallel Session: and Vitiligo Updates 08:30 – Surgical 08:30 – Venue: Hall 4BC 10:30 Chairpersons: Pieter du Plessis, 10:00 Noufal Raboobee

L’oreal Symposium (Branded Session) Research update on African skin: biological and clinical perspectives Venue: MR 22DEFG Chairpersons: Anisa Mosam, Evanson Kamuri

Psoriatic Disease – Beyond Skin and Bone

Novartis Breakfast Symposium Venue: Hall 4AD Sponsored by Novartis

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

Registration

What is new in Microneedling? Why the new Dermapen 4 ?

Nokubonga Khoza, South Africa

Breakfast Symposium 07:00 – GENOP Hall 4BC 08:30 Venue: Sponsored by Genop

07:00

07:00

Programme - Saturday, 1 September 2018

Neglected and mismanaged skin 09:25 – cancers 09:35 Derek Odendaal, South Africa

skin and future 09:40 – Reconstructed 10:00 opportunities Sandra Del Bino-Nokin, France

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

12:00 – The metabolic syndrome - New data and update 12:20 Vandana Chatrath, India

11:40 – Severe cutaneous drug eruptions in Africa in the current global context 12:00 Ranks Lehloenya, South Africa

11:20 – Ten steps to improving your cutaneous surgery 11:40 Glenn Goldman, United States of America

11:00 – The many faces of Lupus 11:20 Jean Bolognia, United States of America

26 09:20 – Skin response to solar light 09:40 Sandra Del Bino-Nokin, France

Plenary Session 11:00 – Combined Hall 4AD 13:15 Venue: Chairpersons: Anisa Mosam, John Masenga, Ayesha Akinkugbe, Vandana Chatrath

10:30 – 11:00

10:20 – Statins in the treatment of vitiligo 10:30 Jonathan Smith, South Africa

strategies in 10:05 – Depigmentation 10:20 vitiligo Nilesh Goyal, India

and how to stabilise vitiligo 09:50 – When in adults children 10:05 Davinderand Parsad, India

Questions and panel discussion 10:10 – Valerie Callender, Cheryl Burgess, 09:35 – Managing Vitiligo in 2018 10:30 Susan Taylor, Andrew Alexis, 09:50 Somesh Gupta, India Vandana Chatrath

use of lasers in facial 09:50 – The melanosis 10:10 Vandana Chatrath, India

Programme - Saturday, 1 September 2018

Galderma Lunch Symposium Photodynamic Therapy – a feasible option for 13:00 – Daylight 14:00 Africa Venue: 22DEFG

27

14:20 – Triple therapy for keloids 15:00 Marc Roscher, South Africa; Nilesh Goyal, India

14:00 – Therapeutic options for keloids 14:20 Marc Roscher, South Africa; Somesh Gupta, India

14:10 – Birth of dermatology in Namibia 14:20 Dagmar Whitaker, South Africa

14:00 – Update on 2018 activities of WDS 14:10 Ncoza Dlova, South Africa

SASDS Parallel Session: Free Workshop: Multimodality to the Treatment of Scars 14:00 – Approach Venue: Hall 4BC 17:00 Chairpersons: Marc Roscher Co-Chairpersons: Somesh Gupta, Noufal Raboobee

Lunch Break / Trade / Poster Viewing - Exhibition Hall

Wolfgang Philipp-Dormston, Germany Dagmar Whitaker, South Africa

DSSA Parallel Session: Women Dermatologic 14:00 – Society Hall 4AD 15:30 Venue: Chairpersons: Dagmar Whitaker, Suretha Kannenberg, Antoinette Chateau

13:00 – 14:00

13:50 – Questions and Close 14:00

13:30 – Surgery and HS 13:50 C Warden, South Africa

13:10 – HS and Crohn’s Disease 13:30 D Epstein, South Africa

12:40 – Overview of HS 13:10 W Visser, South Africa

12:30 – Welcome and IMID overview 12:40 W Visser, South Africa

ABBVIE Lunch Symposium: Painting a new picture the Hidradenitis Suppurativa (HS) Sufferer12:30 – for 14:00 A collaborative approach for optimal Patient management Venue: MR 22ABC

12:40 – Understanding Immunopathogenesis to fuel prevention of serious cutaneous adverse drugs reactions 13:00 Elizabeth Philipps, United States of America

12:20 – The art and science of consultation 12:40 Izolda Heydenrych, South Africa

Programme - Saturday, 1 September 2018

16:45 – Managing Keloids 17:00 Rajan Singh, South Africa

16:40 – Multimodality Approach - case discussion 16:45 Panel

16:30 – Excimer light for improving hypopigmented scars 16:40 Marc Roscher, South Africa; Noufal Raboobee, South Africa

16:20 – Microneedling for acne and other scars 16:30 Marc Roscher, South Africa

16:10 – Sandpapering and dermabrasion for appropriate scars 16:20 Marc Roscher, South Africa

fractional laser for management of stretch 16:00 – Non-ablative and other scars 16:10 marks Noufal Raboobee, South Africa

doctor skills in the procedure room: Back to 16:00 – Patient 16:10 basics Sian Hartshorne, South Africa

16:30 – Hair typology in South Africa 16:45 Kwezikazi Molamodi, South Africa

L’oreal Hair Symposium (Branded Session) 16:30 – Research update on African scalp and Hair: Focus on scalp 18:00 and Characterisation of (Natural) Hair Fibers Chairpersons: Ncoza Dlova and Nonhlanhla Khumalo

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

Registrar Session 16:00 – DRASA Hall 4AD 17:30 Venue: Chairpersons: Sian Hartshorne, Kim Ainsley

15:30 – 16:00

of life of adults with autoimmune bullous 15:20 – Quality in Pretoria 15:30 diseases Tarryn Jacobs, South Africa effect of high SPF sunscreen on Vitamin D 15:30 – The 15:40 production Kim Ansley, South Africa

D levels in adults with autoimmune bullous 15:00 – Vitamin diseases on long-term oral prednisone 15:10 Bonolo Mushiana, South Africa An analysis of inflammatory markers in children with 15:10 – atopic dermatitis in the Greater Tshwane Region 15:20 Rangwesi Olivia Motshabi, South Africa

frequency and spectrum of skin disorders in a 14:40 – The outpatient clinic in Durban, SA 14:50 paediatric Gillian Lawrie, South Africa features of Acral melanoma in 14:50 – Clinico-pathological Africa 15:00 South Johan de Wet, South Africa

14:20 – Pseudofolliculitis Barbae 14:40 Adebola Ogunbiyi, Nigeria

28

Deep Fractional Co2 for assisted drug delivery to burn scars hypertrophic scars 15:00 – and Fractional CO2 for finessing atrophic scars and 15:30 Superficial post-surgical scars Marc Roscher, South Africa

Programme - Saturday, 1 September 2018

Symposium Sponsors

19:00

17:15 – Questions and Discussion 17:30

16:45 – Quizz (Histopath, Medical, Surgical) 17:15 Mamello Ntsele, South Africa

16:35 – Discussion with the experts: 16:45 Robert Brodell, Pedro Jaen, Sian Hartshorne

building skin surgical skills in Northern 16:10 – Capacity a 10-year experience 16:20 Tanzania, Pedro Jaen, Spain 16:20 – Minor procedures for the medical dermatologist 16:35 Robert Brodell, United States of America

29

Gala Dinner

of scalp of African woman 17:30 – Sensitivity Sewraj, South Africa and Ncoza Dlova, South 18:00 Poonam Africa

the impact of grooming and regular braiding 17:10 – Investigating African hair integrity 17:30 on Kwezikazi Molamodi, South Africa

17:00 – Dark & Lovely Education Academy 17:10 Mimmi Biggar

16:45 – Objective evaluation techniques for African natural hair 17:00 Kwezikazi Molamodi South Africa

Programme - Saturday, 1 September 2018

Registration

of skin diseases in 08:45 – Spectrum 09:00 Rwanda Kayitesi Kayitenkore, Rwanda we clinically missing leprosy 09:00 – Are an era of elimination?

09:15 in Neena Khanna, India

in toxins 09:00 – Controversies Heydenrych, 09:10 Izolda South Africa

Onchocerciasis elimination: are 08:30 – we just scratching the surface?

08:45 Michele Murdoch, United Kingdom

Paediatric Dermatoses and Eczema Venue: MR 22DEFG Chairpersons: Jamila Aboobaker, Siza Mazibuko

09:10 – Chronic urticaria 09:30 Jonny Peter, South Africa

Interesting paediatric cases seen at 08:50 – dermatology and regional dermatology 09:10 tertiary clinics in KZN Antoinette Chateau, South Africa

08:30 – Neonatal skin care in Nigeria 08:50 Frances Ajose, Nigeria

DSSA Parallel Session: Infectious Dermatoses 08:30 – Venue: Hall 4AD 08:30 – 10:00 Chairpersons: Hendrik 10:00 Motswaledi, Pakamile Magigaba, Gail Todd

A Gentle Magic explores the resurgence in skin-lightening products in South Africa as an in-road to the country’s changing social landscape. It is a film that explores the issue of skin-lightening and its history, as well as its cultural context, medical implications and possible solutions.

08:40 – Controversies in fillers 09:00 Marva Safa Diana, Switzerland

in the use of 08:30 – Controversies 08:40 sunscreen Sian Hartshorne, South Africa

SASDA Parallel Session : Controversies in Aesthetic and 08:30 – Surgical Dermatology 10:00 Venue: Hall 4BC Chairpersons: Derek Odendaal, Izolda Heydenrych

A multidisciplinary clinic for drug allergy Jonny Peter, South Africa T-Cell mediated SCAR in different populations – can they be prevented Elizabeth Phillips, United States of America Identifying and managing SCAR – where are we in SSA Talks from colleagues

Introduction – why a AFRiSCAR registry Ranks Lehloenya, South Africa

30

Breakfast Symposium: A Gentle Magic - Film screening Venue: Hall 4BC

Tea / Coffee Break / Trade / Poster Viewing - Exhibition Hall

07:00 – Breakfast Symposium: AFRiSCAR Registry 08:30 Venue: Hall 4AD

07:00

07:00

Programme - Sunday, 2 September 2018

Cutaneous Leishmaniasis: A 09:45 – neglected disease in the Naivasha 10:00 District, Rift Valley, Kenya Etemesi Beatrice, Kenya

in Mohs surgery and 09:40 – Controversies 09:50 reconstruction Pieter du Plessis, South Africa

10:00 – The ethics dilemma facing the health system as publicized in the media 10:30 Lukona Mnguni, South Africa

Plenary Session: Ethics 10:00 – Combined Hall 4AD 11:00 Venue: Chairpersons: Percy Naidu, Evanson Kamuri

Panel discussion with the experts: 09:50 – Dermatological surgery 10:00 Glenn Goldman, Derek Odendaal, Pieter du Plessis

Management of chromoblastomycosis: difficulties, challenges 09:35 – and perspectives in developing 09:45 countries Rapelanoro Rabenja Fahafahantsoa, Madagascar

Investigation of a drought associated scabies outbreak in Ethiopia Wendemagegn Enbiale Yeshaneh, Ethiopia

Controversies in dermatologic 09:30 – surgery 09:40 Glenn Goldman, United States of America

Non-surgical management of eyelid 09:20 – BCC 09:25 – 09:30 Derek Odendaal, 09:35 South Africa

Panel Discussion with the experts: 09:10 – Aesthetics – Onyalai: A new African disease Heydenrych, Sian Hartshorne, 09:15 09:20 Izolda 09:25 Bwanali Jereni, Malawi Marva Safa Diana, Ishaan Ramkissonn

Programme - Sunday, 2 September 2018

surge in allergic reactions to 09:50- The 10:00 Kathon Anna Fourie, South Africa

Sensitisation profile on allergens of adult patients having atopic 09:40- and non-atopic diathesis 09:50 attending KCMC Tanzania Juliette Kalikwendwa Kabangire, Tanzania

allergies: Skin prick 09:30 – Diagnostic patch testing 09:40 and Anna Fourie, South Africa

31

Close of congress Ncoza Dlova, South Africa

Notes

11:00

11:00 Tea / Coffee Break and Trade

10:30 – The ethical dimensions of cosmetic dermatology 11:00 Jerome Singh, South Africa

Programme - Sunday, 2 September 2018 32

Oral Abstracts

33

Thursday, 30 August 2018 African hair and skin science: Historical perspectives (George Findlay Lecture: Skin and Hair Science in Africa) Michele Verschoore L’Oréal Research & Innovation, Paris, France; Hospital Saint Louis, Paris, France Africa is characterized by a dynamic demography, a young population, a diversity of cultures and a long standing tradition of enhancing beauty.

Today, thanks to major efforts in health maintenance, diseases prevention and to economic growth, we observe a trend to the decrease of infectious diseases with medical research having paved the way for this important social progress. However, regarding skin care and hair care, the lack of Hair and Skin physiology research in Africa was significant two decades ago and prevented inventions specific to African people.

L’Oréal, the number one cosmetic company in the world has been visionary by implementing numerous basic science and applied sciences projects on African Hair and Skin. These works allowed to identify the wide diversity of hair shape and to decipher the specific biologic pattern of frizzy hair, at the origin or its extreme fragility. On the other hand, a major insight in skin colour diversity has been elucidated. These important research discoveries paved the way for innovative and adapted cosmetics for Africans in their specific environment.

These discoveries were also shared for more than 20 years with the African Dermatology Community to stimulate discussions and scientific partnerships. Today, we are convinced that adequate education campaigns for the maintenance of healthy hair and skin along with an offer of Hair and Skin Care cosmetics inspired by these biological works, are the turning point for safe Beauty for all in Africa.

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Oral Abstracts

35

Friday, 31 August 2018 Skin microbiota – why we WANT bacteria on our skin for a “healthy glow” Ilsa Orrey Private Practice, Cape Town, South Africa The skin, which is also the largest organ of the body, is colonized by a diverse collection of microorganisms. Amongst these are at least 1000 different species of bacteria and 80 different species of fungi.

Most of these organisms are non-pathogenic commensals or mutualistic, aiding in the optimal functioning of the host as well as enhancing the immune system of the host. Most of the microorganisms are found in the superficial epidermis, but bacteria have been isolated in the upper parts of the hair follicles as well as the dermis and subcutaneous fat. This allows physical contact and interaction of bacteria with the cells beneath the basement membrane. The colonization is highly variable depending on the location the skin. Skin folds, hairy areas, dry areas, moist areas, areas exposed to light etc. all have different microbiomes. Also, the microbiome changes with age, and is dependent on the sex of the person.

Bacteria benefit the skin by preventing colonization with pathogens by competing with nutrients, secreting chemicals that are detrimental to the pathogen, or by stimulating the immune system.

This talk will focus on the effect of adding “good” bacteria to cosmetic products to treat a variety skin conditions.

Ethnic Beauty…how to incorporate the use of hyaluronic acid filler Ishaan Ramkisson The uniqueness of the face helps in determining a person's origin and race. Facial features and proportions differ with race. Therefore, it is increasingly important for professionals whose work involves correction of facial anomalies and achieving aesthetics to be aware of the differences in facial characteristics among ethnic/ racial groups. Hyaluronic Acid Fillers / Dermal Fillers use is increasing worldwide and has proven to be an effective tool in treating the ethnic aesthetic patient.

Today we will discuss how to incorporate Hyaluronic acid fillers in your practice.

Oral Abstracts

36

Friday, 31 August 2018 Connective tissue diseases in Africa – an update Christopher Roland Lovell Royal United Hospital, Bath, United Kingdom Several connective tissue diseases have traditionally been regarded as rare in Africa, however this probably reflects under-reporting.

In this presentation, I aim to review some current aspects of major connective tissue diseases, with reference to recent publications on the subject.

The prevalence of systemic lupus appears to be similar in people of African descent resident in Africa to those resident in America, however it has a poorer outcome in Africa. Children, in particular, are at risk of severe systemic disease including lupus nephritis, neurological and haematological complications.

Classification of subsets of dermatomyositis has been transformed by the identification of numerous myositis – specific autoantibodies, which in some cases have prognostic significance. Some antibodies are associated with primarily cutaneous disease and others with calcinosis and vasculitis, complications particularly prevalent in children. Underlying malignancy should always be considered and there may be a case for “blind” screening where there is a strong suspicion of malignancy.

Systemic sclerosis may be associated with renal impairment, which can be ameliorated by drugs such as ACE inhibitors. Pulmonary hypertension is a silent killer; it is worth screening asymptomatic patients, since therapy (which includes drugs such as sildenafil) can dramatically improve life expectancy.

Global health dermatology Claire Fuller The International Foundation for Dermatology has been carrying out the humanitarian work of the International League of Dermatological Societies since 1987. The talk will present a range of recent projects undertaken with the IFD from advocacy and international influence, to capacity building and teaching.

Oral Abstracts

37

Friday, 31 August 2018 Cutaneous melanoma in people of African descent Anaba Ehiaghe Lonia Lagos State University Teaching Hospital, Lagos, Nigeria Cutaneous melanoma is a malignancy with a worldwide incidence. Literature is replete in the Caucasian population but in people of African descent (PAD), there is a dearth of literature. Documented reports of the epidemiology of cutaneous melanoma. The aim of this study was to identify the clinical, histopathological characteristics, variants and genetics of melanoma in PAD. Also, to identify any other difference between melanoma in people of African descent and other skin types.

PubMed, Google Scholar, Ovid and Embase were systematically searched and reviewed for published articles which included the search words. The search words used included; cutaneous melanoma, blacks, whites, Caucasians, skin of colour, ethnic skin, African Americans, differences between ethnic groups. One hundred and seventy-three papers were reviewed with sixty-six specifically addressing cutaneous melanoma in PAD. Melanoma does occur in PAD, commonly acral. The commonest histopathological pattern is acral lentiginous melanoma. There are as yet no observed differences in the histopathology of melanoma in PAD and in Caucasians. People of African descent have a low awareness of cutaneous melanoma with consequent advanced lesion presentation, ulcerated lesions and poor survival. The genetics of melanoma in PAD has not been well studied. The only available study on the genetics of melanoma reveals a difference in melanoma genetics between PAD and Caucasians.

In people of African descent, due to the low incidence of melanoma, melanoma is commonly misdiagnosed. This misdiagnosis can be both clinical and histopathological.

A high index of suspicion should be entertained of any hyperpigmented lesion in PAD especially if it is acral and a histopathological assessment should be made.

Oral Abstracts

38

Friday, 31 August 2018 Metastatic in-transit nodular malignant melanoma mimicking sporotrichosis Olutomidimu Afolabi Nigerian Association of Dermatology, Senior Registrar, OAUTHC. Ile-Ife, Nigeria In-transit metastasis from malignant melanoma occurs when nodules develop within the lymphatic channels between primary and regional lymph nodes. Tumour nest occurs 2cm beyond the primary tumour but not beyond the regional lymph nodes.

We describe a 70-year-old African woman who presented with 6 months history of itchy nodules located on the right distal forearm measuring 6cm x 4cm x 3cm in its widest diameter with multiple smaller, skin coloured nodules arranged in a sporotrichoid pattern around the elbow each measuring 1cm x 1cmx 0.5cm in their widest diameter. No palpable axillary lympnodes. Histology showed malignant proliferation of large atypical melanocytes which were arranged as single cells, nest and diffuse sheets with tumour cells infiltrating the dermis and subcutaneous layers.

Local- regional metastasis of malignant melanoma could include regional lympnodes metastasis, local recurrence, satellite metastasis in which new lesions develop within 2 cm of the primary lesions and in-transit metastasis occurring along lymphatic channels greater than 2cm distance from the primary lesion without affecting the regional lympnodes. The index case initially had two ulcerated nodules with numerous smaller nodules arranged along the lymphatic drainage of the right upper limb resembling sporotrichosis also known as nodular lymphangitis, a subcutaneous fungal infection characterized by multiple subcutaneous nodules that progress along dermal and lymphatic vessels.

Metastatic in-transit nodular malignant melanoma carries an unfavourable prognosis.

Early presentation by patients and prompt diagnosis will help in reducing the associated morbidity and mortality.

Oral Abstracts

39

Friday, 31 August 2018 Increased number of drug induced pellagra cases in Blantyre, Malawi following rolling out of isoniazid preventive therapy against active tuberculosis among HIV positive persons Kelvin Mponda Dermatology Department, Queen Elizabeth Central Hospital, Blantyre, Malawi Tuberculosis has high mortality in HIV infected persons in sub-Saharan Africa. To prevent these deaths, Malawi introduced isoniazid preventive therapy (IPT) against active tuberculosis in HIV positive persons living in 10 high TB burden districts from where 75 % of all TB cases in the country are diagnosed. Full IPT roll in Blantyre in September 2017 was followed by an upsurge of pellagra cases at Queen Elizabeth Central hospital (QECH) 2 months later. Isoniazid structurally resembles niacin and causes pellagra through competitive inhibition of the vitamin. This study was aimed at reviewing the cases of pellagra in seen in the clinic to find evidence of possible link with the IPT initiation. A retrospective clinical audit of documented pellagra cases was conducted at the department of dermatology, Queen Elizabeth Central Hospital covering the period from January 2017 to April 2018.

One hundred and thirty-six cases of pellagra were recorded during the study period, of which 119 (88 %) were female. By HIV status, 99 cases (73 %) were HIV positive, followed by 29 (21 %) that were HIV negative and 8 (6 %) that were HIV unknown. Over three quarters (104 cases) presented between November 2017 and April 2018 of whom 92 (88 %) were HIV positive and on IPT. On trends during the same months of the periods before and after rolling out IPT, only 3 cases were seen at the peak of the harvesting season in March (3 cases) and April (0 cases) in 2017 compared to 35 (17, 18) in 2018. Overall 12 cases had been seen from January to April 2017 (HIV status: 2 positive, 2 negative and 8 unknown) compared to 70 (64, 6, 0) in the corresponding period in 2018 respectively.

While the observed increase in cases of pellagra among HIV positive patients that extended from the planting, food lean season through the harvesting, food plenty season following IPT roll out a few months earlier weakens possibility of reduced dietary niacin intake, further confirmatory studies are needed to identify direct association with IPT. This will guide policy direction on IPT given the public heath significance of tuberculosis in Malawi.

Oral Abstracts

40

Friday, 31 August 2018 Histological patterns of mucocutaneous tumours and other lesions seen in patients with xeroderma pigmentosum attending Regional Dermatology Training Centre Northern Tanzania Lulyritha Christian Kini Kilimanjaro Christian Medical University College, Moshi Kilimanjaro, Tanzania Xeroderma pigmentosum (XP) that literally means dry pigmented skin is a rare autosomal recessive genodermatosis with extreme sensitivity to sunlight, resulting in sunburn, pigment changes in the skin and a greatly elevated incidence of skin cancer. XP in Africans is characterized by very early development of cutaneous and mucosal malignant tumors such as squamous cell carcinoma leading to early mortality due to metastasis.

The objective of this study was to determine the histological pattern of mucocutaneous tumors and other lesions among patients with XerodermaPigmentosum who were attended at the Regional Dermatology Training Centre, Nothern Tanzania.

This was a hospital based retrospective cross- sectional study. The records of all the patients with XP who were attended at Regional Dermatology Training Centre between 2005 and 2014 were reviewed. The sociodermographics data, number of XP patients and number of mucocutanoeus tumors and other lesions which were sent for histology was reviewed.

There were 35 patients involved in this study. The median age was 8 years, majority were at the age category of 5-15 years. Majority were the males 20(57.1%) and the females were 15 (42.9%). Of the 35 XP patients, 80% of them had developed mucocutaneous tumors and most of them with multiple tumors at the time of attendance. There were 79 occurrences of tumors in the course of follow-up of these participants. Of these 79 samples, 36 were malignant tumors (45.6%), 26 were benign tumors (32.9%) majority being pyogenic granuloma (46.2%). Other lesions were 17(21.5%) with majority of them being hypertrophic scars 6 (35.3%). Of the 36 malignant tumors, the total number of patients with squamous cell carcinomas were 24, basal cell carcinomas were10 and melanoma s were 5. The commonest site affected was the scalp (30.3%). For the 28 participants with tumors 24(85.7%) had excision, 4 (14.3%) had Aldara as their initial management strategies. All 4 patients who were managed with Aldara had excisions in their subsequent visits.

1 patient (3.6%) had Aldara and two excisions in the two subsequent visits.

Oral Abstracts

41

Friday, 31 August 2018 Oral pre-cancer and cancer Marcia Ramos-e-Silva Premalignant and malignant lesions of the oral mucosa comprise a group of major importance to the Dermatologist, Dentist, Otorhinolaryngologist, Head & Neck and Buco-Maxillo-Facial Surgeon and Stomatologist.

Precancerous lesions and conditions are, respectively, morphologically altered tissues and generalized states in which cancer occurs more frequently. In the oral mucosa, leukoplakia, erythroplasia, actinic cheilitis and nevus are considered precancerous lesions; and among the precancerous conditions are atrophic glossitis due to several causes, such as anemic conditions, candidiasis and tertiary syphilis, xeroderma pigmentosum, lichen planus and lupus erythematosus, among others.

Among the already malignant lesions, squamous cell carcinoma is responsible for 90% of malignancies of the mouth and, among the intraoral, 50% are on the tongue.

The mouth may also be the site of basal cell carcinoma, usually by contiguity to a lesion located on the skin, melanoma, and even metastases, which may be the first sign of severe internal neoplasia.

For the installation of these tumors it is often necessary the action of triggering or aggravating factors, among them smoking, alcohol, virus, sun and chronic traumatism.

The recognition of lesions and pre-malignant states, as well as the early diagnosis of an already installed cancer, is of the utmost importance in order to combat them, eliminate aggravating factors, and thus improve the prognosis regarding quality of life and the survival time of these patients.

The spectrum of blistering diseases in the Northern zone of Tanzania: A seven years retrospective study at the Regional Dermatology Training Centre (RDTC) Elisante John Masenga Ministry of Health, Dar-es Salaam, Tanzania, Regional Dermatology Training Centre (RDTC), Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania Blistering diseases are associated with substantial morbidity some of which (though few) may cause death. The study was therefore aimed to describe the whole spectrum of vesiculo-bullous dermatoses (VBD) in a population mostly inhabited by Black Africans.

This was a seven years retrospective study of all cases which presented with veiculobullous Dermatoses. The diagnosis was mainly clinical and/or Histological pattern of congenital, inherited or acquired VBD.

Oral Abstracts

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Friday, 31 August 2018 A total number of 146 cases were recorded representing 0.74% of all dermatological conditions during this period. Sub-epidermal Immuno-Bullous disorders were the commonest (60.3%) compared to intra-epidermal bullous (39.3%) mostly Pemphigus folliaceus.

The study suggest Vesiculo-bullous diseases are not uncommon and there is a probable existence of endemic focus of Pemphigus folliaceus in this Northern part of Tanzania.

Micro needling in ethnic skin Pholile Mpofu There are risks of complications e.g. hyperpigmentation and keloid formation in reparative skin procedures such as chemical peels, laser therapies, dermabrasion etc. Micro needling has a safer outcome compared to the other treatment methods.

Micro needling is effective for various conditions, eg: hyperpigmentation, mild acne vulgaris, hypertrophic scars and keloids, skin rejuvenation; alopecia and primary hyperhidrosis. This talk will highlight the safety and use of micro needling in skin of colour.

A practical approach to disorders of hypo- and hyperpigmentation (John Moche Memorial Lecture) Jean Bolognia Yale School of Medicine, New Haven CT, United States of America One approach to disorders of pigmentation is to divide both hypo- and hyperpigmentation into the following categories: (1) diffuse; (2) circumscribed; and (3) linear. In the case of hypopigmentation, a fourth category consists of guttate leukoderma whereas the fourth major form of hyperpigmentation is reticulated.

By far, the most common category is circumscribed, and it is the one that is further subdivided into partial decrease [hypomelanosis] versus complete absence [amelanosis] in the case of hypopigmentation and epidermal versus dermal in the case of hyperpigmentation. However, it is important to remember that these disorders exist on a spectrum and both overlap, and admixture can be observed.

In order to simplify matters, a second step is to have a “marquee� diagnosis for each of the major divisions. The marquee diagnosis tends to be the one that is most commonly encountered and therefore the one that is most familiar to the clinician. An example would be vitiligo for circumscribed amelanosis. The differential diagnosis is then generated based on the clinical and histological features. The greater the number of factors that do not support the marquee diagnosis, the greater the need to consider a wider differential diagnosis and to consider rarer entities that can have a similar appearance, e.g. the leukoderma of melanoma or the leukoderma of scleroderma.

Oral Abstracts

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Friday, 31 August 2018 Vulval ulcers Claire Fuller Vulval ulceration is most commonly attributed to viral infections but there are other causes. Relieving discomfort for the patient while the diagnosis is established is a crucial part of management. This short summary will touch on a number of causes of vulval ulceration and highlight some treatment tips to keep your patients comfortable.

Rational approach to the treatment of melanoma Glenn D. Goldman UVM Medical Center, Burlington, VT, United States of America Treatment of facial melanoma in situ and early invasive MM is problematic. Lesions are broad and ill-defined. This lecture will address the appropriate forms of surgical intervention for facial MIS, including the use of Mohs surgery with MART-1 immunohistochemistry and/or the use of excision with en face permanent sections.

Disseminated giant hyperkeratotic porokeratosis and treatment with acitretin Minette Swart Division of Dermatology; Department of Medicine; Faculty of Medicine and Health Sciences; Stellenbosch University, Cape Town, South Africa The porokeratoses are a family of hereditary and acquired disorders of keratinization that share a distinctive clinical and histopathological appearance. The cornoid lamella is the histopathologic hallmark of the various types of porokeratoses. Included in the recognized clinical entities that constitute this group, rare hyperkeratotic variants have been described.

This case is reported as a unique presentation of the hyperkeratotic variant of porokeratosis. A 40-year-old male patient presented with disfiguring disseminated lesions in the setting of intense chronic sun exposure, intravenous drug abuse and immunosuppression due to human immunodeficiency virus infection.

Based on previous case reports a trial of Acitretin (25mg daily) was initiated and the most likely triggering factors, namely UV exposure and immunosuppression due to AIDS, were addressed by encouraging strict sun protection and compliance with highly active antiretroviral therapy.

The patient will be followed to monitor the response to treatment and for the development of complications.

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Friday, 31 August 2018 Radiofrequency assisted liposuction and skin tightening has since met our expectations Fatmah Ghoram Alshehri Prof. Lawrence M. Field, Father of Dermatologic Plastic Surgery, Hellenic Society DS, South African Soc Derm Surg, DASIL, ASDS, San Diego, United States of America Tumescent Liposuction is a procedure that has gained high acceptance over the past few years between physicians and patients owing to its high safety profile and satisfactory clinical outcome. However, the problem of skin laxity after liposuction had not been solved yet by physicians nor medical technology companies. Medical technology companies have worked hard to find the best technology that can aid skin tightening while performing liposuction. Physicians have used different wavelengths of lasers, ultrasound waves and more recently bipolar radiofrequency waves with variable outcomes and some limitations.

Over the past 18 years driven by profound interest in body contouring and liposuction, having the chance to work on multiple energy-based devices, revising literature, observing patients and communicating with colleagues who have the same interest and challenge I found that bipolar radio frequency is the most rewarding energy for skin tightening while performing liposuction. Bipolar radiofrequency helps to liquefy and coagulate fat and vascular tissue causing contraction of the fibroseptal network leading to skin contraction of about 30-40 percent provided that the physician has excellent knowledge of radiofrequency - tissue interaction, experience in proper patient selection can manage patients expectations. In this presentation I will be discussing the basic science behind Radio Frequency Skin Tightening, some of the practical tips and tricks that can help the physician to obtain good results and avoid possible side effects.

Ichthyosis with Confetti Saskya Claasens Stellenbosch University, Cape Town, South Africa Ichthyosis with Confetti (IWC) is a rare autosomal dominant congenital ichthyosis caused by frameshift mutations in KRT10 (type 1 IWC [IWC-I]) or KRT1 (type 2 IWC [IWC-II]). The hallmark of this keratinizing disorder is the appearance of pale, genetically revertant macules on a background of erythrodermic, diseased skin.

Affected individuals with IWC-I display phenotypes distinct from those with IWC-II. IWC-II is extremely rare with the second kindred reported by Suzuki et al (2016).

I present a kindred involving three generations where the proband exhibits an IWC-II phenotype. DNA testing did not detect pathogenic variants of KRT10 or KRT1 in the proband’s blood. Elucidating the underlying genetic mutation in the kindred presented is complicated by a resource limited setting but could potentially provide useful insights into this rare genodermatosis.

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Friday, 31 August 2018 The Disney masquerade: Talaromyces marneffei Nerissa Moodley Department of Dermatology, University of Kwa-Zulu Natal, South Africa Talaromyces marneffei (formerly Penicillium marneffei) is a dimorphic fungus that causes a systemic fungal infection referred to as talaromycosis. It is an important cause of morbidity and mortality in HIV infected and other immunosuppressed patients who live in or are from endemic areas. Although the mode of transmission of T marneffei is unknown, an airborne route via inhalation of conidia from an environmental reservoir is suspected.

We report the case of a 35-year-old female that presented with a 2 month history of generalised, ulcerated papules, plaques and nodules. The clinical presentation was that of a deep fungal infection such as histoplasmosis and cryptococcosis however on microscopy, yeast like bodies were observed and T marneffei was cultured.

To date there has been only 1 other documented case in South Africa highlighting this rare disease. This report will focus on its rarity, associations, therapies and to communicate the importance of early diagnosis. The correlation of clinical findings with histopathology and microbiology is essential for the management of this disease.

Pseudoxanthoma elasticum with sarcoidal granulomatous reaction Kim Ansley University of Pretoria, Pretoria, South Africa A 42-year-old, otherwise healthy female, presented with a long-standing history of skin laxity affecting the axilla and the clinical findings were suggestive of one of the heritable disorders of connective tissue. The characteristic features of Pseudoxanthoma Elasticum (PXE) confirmed the diagnosis histologically. However, the patient also gave a history of a recent onset of asymptomatic, erythematous papules and plaques on her upper trunk, a biopsy of which identified non-caseating granulomatous inflammation with Langhans giant cells, some containing asteroid bodies, intermixed with fragmented elastic fibres. A final diagnosis of PXE with a sarcoidal reaction was made. PXE is a rare genetic disorder with progressive calcification and fragmentation of the elastic fibres primarily affecting the skin, retina, and blood vessels. A sarcoidal granulomatous reaction in PXE is a rare presentation with few reported cases worldwide and it is currently unknown as to why certain PXE patients develop this granulomatous reaction and others do not. There are conflicting ideas in the literature as to whether this reaction is part of the PXE disease spectrum or a separate disease entity all together and further exploration in this regard may shed light on the matter.

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Friday, 31 August 2018 Arose amongst the thorns Pumeza Unathi Makaula University of KwaZulu-Natal, Durban, South Africa Body art in the form of tattoos has become an exceedingly common practice in modern day, with new trends arising on a daily basis. Its increased prevalence has led to a rise in report of cutaneous reactions. Transient acute inflammatory reactions, superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions have all been extensively reported in the literature. The current case demonstrates a very unusual reaction pattern to tattoo ink. A 59-year-old female presented with acute swelling over a multi-coloured tattoo on her right ankle and leg immediately following the tattooing procedure, with subsequent development of painful nodules only within the red-inked areas.

Histology demonstrated features of keratoacanthoma within the red inked-areas.

Keratoacanthomas are squamous cell neoplasms of unknown origin that grow rapidly. They may be single or multiple and numerous types have been described including trauma-induced KA’s. Whilst there have been a few reports of KA’s arising within tattoos, it is an extremely rare occurrence. This case therefore displays a very unusual clinical presentation of a reaction to tattoo ink.

Family Ties: A familial case of tuberous sclerosis complex Mndeni Lindokuhle Kunene Division of Dermatology, Walter Sisulu University, Nelson Mandela Academic Hospital, Mthatha, South Africa Tuberous sclerosis complex (TSC) is an inherited neurocutaneous disorder that occurs in approximately 1 in 7,500 live births. It is characterized by benign neoplasms of the skin, heart, kidneys, lungs, central nervous system, and mucosa. Around twothirds of TSC cases are new dominant mutations, so there is often no family history.

The classic triad is seizures, mental retardation, and cutaneous angiofibromas.

However, the full triad occurs in only 29% of patients; 6% of them lack all three of them. Two tumor suppressor genes responsible for TSC have been identified: TSC1 gene on chromosome 9 and TSC2 on chromosome 16; which encode hamartin and tuberin, respectively, were discovered in the 1990s, and their functions were elucidated in the 2000s.

We describe a 36-year-old father who presented with facial angiofibromas, hypomelanotic macules and ungula fibromas. Further investigations revealed the presence of subependymal giant cell astrocytomas, renal cell carcinoma and renal angiomyolipomas. His two sons aged 14 and six years also have tuberous sclerosis.

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Friday, 31 August 2018 Cutaneous findings in TSC should be regarded as cutaneous signs of a pivotal systemic disease. The genetics of tuberous sclerosis and the variety of neoplasms seen in TSC patients along with their clinical significance will be discussed as well as evaluation and management strategies.

When atypical is atypical: Mycobacterial infection in an immunosuppressed patient Tarryn Jacobs University of Pretoria, Pretoria, South Africa Infection with non-tuberculous mycobacteria (NTM) also known as atypical mycobacteria is becoming more prevalent with the rising incidence of immunosuppression. NTM are more commonly encountered in organ transplant recipients and patients with HIV. NTM infections have also been described in patients with autoimmune diseases in isolated case reports, especially in those with systemic lupus erythematosus (SLE). We describe a case of cutaneous Mycobacterium fortuitum in a patient with SLE/ Scleroderma overlap syndrome. We discuss the clinical features and histopathological patterns that seem to be more prevalent in immunosuppressed patients.

Male pattern androgenic alopecia in two post-menopausal women Lerinza van den Worm Department of Dermatology UCT, Groote Schuur Hospital, Cape Town, South Africa Male pattern androgenic alopecia (AGA) in a female is a sign of hyperandrogenism and is extremely rare in postmenopausal women. Where hyperandrogenism in young females are fairly common and predominantly due to polycystic ovarian syndrome (PCOS), new onset hyperandrogenism in postmenopausal females are likely the result of either an androgen secreting tumour or ovarian hyperthecosis.

Patient A, a 57-year-old postmenopausal female presented with a longstanding history of alopecia over the vertex of her scalp and over the last year loss of her frontotemporal hair. Patient A had a serum testosterone level of 19.2 nmol/L (reference range 0.1-1.4 nmol/L). A transvaginal ultrasound revealed an enlarged right ovary and a solid tumour of the ovary was suspected.

Patient B, a 64-year-old postmenopausal female presented with a 1-2 year history of alopecia of her frontotemporal and crown area. Patient B also had an elevated serum testosterone of 9.0 nmol/L (reference 0.1-1.4 nmol/L). Further investigation done by the gynaecology department included a transvaginal ultrasound that showed a left pelvic ovarian mass, and an abdominal CT scan that confirmed the left pelvic ovarian mass.

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Friday, 31 August 2018 Patient A: Because of comorbidities the mass could not be removed Patient B underwent an oophorectomy and mature cystic teratoma was detected, the cyst contained skin with adnexal structures (apocrine glands, sebaceous glands and hair follicles), bone, cartilage, respiratory epithelium and glial tissue.

We report on two cases of postmenopausal women with male pattern AGA that were found to have markedly elevated testosterone levels. Upon further evaluation both patients had ovarian masses detected on ultrasound, one patient had a mature cystic teratoma and the other patient is not a surgical candidate due to multiple comorbidities.

It is important to detect male pattern AGA in postmenopausal woman and to appropriately investigate for hyperandrogenism since, although a rare condition, an androgen secreting tumour might be the cause. A detailed history, serum testosterone and dihydroepiandrosterone sulphate (DHEAS) measurement should be performed as screening tests.

Intertriginous ulcers in an adult Aimee Gavin University of Limpopo and Pietersburg Provincial Hospital, Polokwane, South Africa A 28-year old male with no comorbidities presented with a four-year history of painful, non-pruritic skin lesions affecting the intertriginous folds. Examination revealed multiple polymorphous, superficial ulcers and erosions in the axillae, intergluteal fold and the anogenital area of the obese patient. After clinicopathological correlation, the diagnosis of Langerhans cell histiocytosis was made.

This case report will highlight the different clinical presentations of and frequent disease associations with adult-onset Langerhans cell histiocytosis.

Linear morphea with synpolydactyly in a South African infant Nkeiruka Elsie Ezomike Division of Dermatology, Red Cross Children’s Hospital, Rondenbosch, Cape Town, South Africa; Department of Paediatrics, University of Nigeria Teaching Hospital (Unth), Ituku-Ozalla, Enugu, Nigeria Linear morphea is a rare localized scleroderma (LS), most common subtype seen in children characterized by thickening of the skin and underlying tissues in linear bands which usually involves the limbs leading to significant deformities.

Transforming growth factor regulated by fibrillin-1 (FBN1) gene has been implicated.

Synpolydactyly, which rarely involves the thumbs may result from mutation of this gene. Here we report this first case of linear morphea in a South African infant with synpolydactyly of the thumbs and review literature pertaining to this disease.

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Friday, 31 August 2018 Case report and MEDLINE (Pubmed) search of the English literature using the words ‘linear morphea and synpolydactyly’.

A 4-month-old presented with progressive skin hardening of the lower extremities since the age of six weeks following diphtheria, pertussis and tetanus (DPT) vaccination at the thigh.

Examination revealed linear plaques, symmetrical, with puckered appearance and woody non-pitting induration extending from the lateral aspects of both thighs to the feet and toes.

Histology revealed band of dermal fibrosis and thickened collagen. The epidermis and subcutis were unremarkable.

Patient was commenced on parenteral methotrexate and prednisolone with subsequent remarkable improvement. A total of 16 cases of linear morphea in infants are described in the literature but none coexist with synpolydactyly.

Linear morphea is a rare disorder which can be associated with synpolydactyly.

The presence of skin thickening with syndactyly should strengthen the suspicion of morphea. This knowledge will facilitate early diagnosis and management to prevent attendant morbidities.

Paraneoplastic scleromyxedema with Non-Hodgkin Lymphoma – A rare presentation Musonda Sharon Machona Division of Dermatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Scleromyxedema is a rare, chronic primary cutaneous mucinosis with unknown pathogenesis characterized by a generalized papular and sclerodermoid induration that usually occurs in association with monoclonal gammopathy. Only a few cases associated with neoplasms have been reported. We report a case of paraneoplastic Scleromyxedema with Non-Hodgkin lymphoma.

A 48-year-old man presented with a three week history of a generalized skin eruption associated with pruritus and hardening of the skin. He was previously successfully treated for Diffuse large B-cell lymphoma a year before. He was HIV negative with no co-morbidities and denied use of medication prior to the eruption.

Examination revealed a widespread monomorphic papular eruption involving the face and body. The papules were closely spaced, some coalescing to form plaques, with underlying thick, immobile and shiny skin. He also had generalized lymphadenopathy.

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Friday, 31 August 2018 Histology of the papules showed increased collagen deposition, fibroblast proliferation and diffuse mucin deposition highlighted by Alcian blue stain. Thyroid and autoantibody screening produced negative results. Serum protein electrophoresis and immunofixation showed a small peak of monoclonal igG lambda. A diagnosis of Scleromyxedema was made. Histology and immunohistochemistry of the lymph nodes revealed a relapse of the Diffuse large B-cell lymphoma.

The association between malignancy and Scleromyxedema has been rarely described.

To our knowledge only 2 reported cases of an association with Non-Hodgkin lymphoma. In our case, indurated cutaneous lesions resolved spontaneously after starting chemotherapy. Progressive improvement without treating the skin suggests the paraneoplastic association. Paraneoplastic eruptions might have a better prognosis after surgery or chemotherapy.

Swift’s not dead. Can you see he’s still Pink?

Jeremy David O’Kennedy Department of Dermatology, University of the Free State, Bloemfontein, South Africa An extraordinary case report of a second case of severe Infantile Acrodynia seen in a 6month period within our Academic complex. In both cases the diagnosis was made after months of delay, with severe consequences, due mostly to a lack of knowledge and the ‘lost/forgotten’ ability to recognize the sign and symptoms of Mercury poisoning [A disease presentation erroneously thought to of purely historic consequence by many physicians today] among specialist colleagues within other specialties.

This case clearly and poetically demonstrates how knowledge of the so-called rare and obscure diseases and syndromes often becomes the ‘life-saving expertise’ for the yet undiagnosed and scared sufferers.

Histoid leprosy Slindile Buthelezi We present 2 recent cases of uncommon presentation of leprosy. Histoid leprosy is a clinically distinct form of multi bacillary disease that some authors classify as a variant of lepromatous leprosy. It has been described in a setting of Dapsone resistance, with some cases occurring de novo. It has been historically characterised by dermatofibroma like lesions but recently, Molluscum contagiosum like lesions have been described.

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Friday, 31 August 2018 Autologous fat transplant Nilesh N Goyal Dermatologists, more so Cosmetic Dermatologists, take great pride in using fillers to obliterate lines and dents from faces of people. These filler materials cost a huge amount for the patients and doctors alike. However, fat extracted from the patients own belly or thigh is virtually free of cost and side effect free, it being the patients own body tissue. Autologous fat transfer gives the freedom to fill large areas at minimal cost giving the doctor lots of material to work with and, in turn, have a more satisfied patient. Though fat transferred has a shorter life than synthetic filler and needs to be repeated, the long-term survival of fat after multiple sessions has been well documented in the literature. An added feature seen after Fat injections has been that the overlying skin shows a marked improvement in texture and quality.

One of the most recent advantages fat has over hyaluronic acid fillers is the presence of stem cells or adipose derived regenerative cells that have the potential to increase derma thickness which is lost as part of aging and disease processes.

The presenter aims to show versatility of fat as filler for dermatologic and cosmetic indications. In particular, fat is shown as a tool for reconstruction of facial features in case of long standing morphoea, in treatment of depressed atrophic scars post-surgery and post burns. Fat works wonders when used for facial rejuvenation.

Approach to facial reconstruction Glenn D. Goldman UVM Medical Center, Burlington, VT, United States of America Instead of a “pyramid� approach to reconstruction of the face this lecture seeks to develop more of a gestalt approach. Special attention will be paid to patient factors as they affect the choice of reconstructive options.

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Saturday, 1 September 2018 Medical, surgical and cosmetic treatments for hair loss in women of colour: An update Valerie D. Callender Howard University, Washington, DC, USA Hair Loss can have a negative impact on quality of life, especially in women. Many of the causes of alopecia are not well defined and treatment options are limited or challenging for the physician. Correct diagnosis is key and will guide management plans, patient expectations and treatment outcomes. Common causes of hair loss in women of colour include acquired trichorrhexis nodosa, traction alopecia, female pattern hair loss, central centrifugal cicatricial alopecia and frontal fibrosing alopecia.

Early diagnosis, aggressive medical treatment, often combined with camouflage techniques, and in some cases, surgical intervention, are strategies to maximize therapeutic results. This presentation will review a multi-targeted approach to treating hair loss in women of colour, including specific medical, surgical and cosmetic therapies and provide recommendations for customizing and combining these treatments for an overall successful outcome.

Cosmetic procedures in black skin Cheryl Marie Burgess Georgetown University, Washington DC, USA; George Washington University, Washington DC, USA; Centre for Dermatology and Dermatologic Surgery, Washington DC, USA Challenges in Aesthetic Treatment in Ethnic Skin. Biological differences along with cultural differences are important considerations that impact the use and results of cosmetic procedures. Aside from patient’s goals and expectations, there are numerous factors that affect the success of cosmetic procedures in skin of colour.

Cosmetic concerns and therapeutic considerations in skin of colour: With the demand for minimally invasive cosmetic procedures, it is becoming increasingly important for clinicians to be aware of specific and unique needs, in addition to, the possible complications that may occur in people of colour. The discussion will familiarize the clinician of the most common adverse events.

Experience as the first South African trained Mohs micrographic surgery fellow Nivana Ramlachan “Non est ad astra mollis e terries via” – There is no easy way from the earth to the stars. These words aptly describe my Mohs fellowship. In this presentation, I will share my experience as a Mohs fellow over the past year, outlining my journey and growth in dermatological surgery, culminating in my fellowship as the first South African fellow. I had the great privilege of receiving stellar training at the Skin matters Mohs Micrographic Surgery unit from Dr Pieter du Plessis, ASDS

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Saturday, 1 September 2018 Fellowship director. I will highlight the course curriculum and share interesting cases and the benefits and my experience of deliberate practice.

Mohs surgery at the Regional Dermatology Training Center (RDTC) Daudi R Mavura Regional Dermatology Training Center Moshi, Tanzania Mohs micrographic surgery has been refined into the most advanced, precise, and effective treatment types with the Mohs techniques, physicians can precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed. Mohs surgery is the most effective treatment for most types of skin cancer.

Mohs surgery is unique and so effective because of the way the removed tissue is microscopically examined evaluating 100% of the surgical margins. The pathologic interpretation of the tissue margins is done on the site by the Dermatopathologist and Mohs surgeon. Advantages of Mohs surgery include Ensuring complete cancer removal, minimizing the amount of healthy tissue lost, maximizing the functional and cosmetic outcome resulting from surgery, curing skin cancer when other methods have failed.

It has been seen that Mohs Surgery is cost effective due to high success rate and most patients require only a single surgery including the repair of the wound.

There are several challenges when performing Mohs surgery depending on the team needed to perform proper Mohs Surgery. For the past 4 year the Regional Dermatology Training Center at Moshi Kilimajaro Tanzania we have been performing Mohs surgery for the People with Albinism (PWA) and other patients with recurrent skin cancers not responding to the conversational surgery.

Mohs Micrographic surgery provides complete microscopic margin control through the use of Horizontal frozen histologic sections of the entire periphery of the excised tumor by use of the cryostat machine.

Mohs surgery has few complications with proper preoperative planning but can be a time intensive procedure. It has a cure rate of 99%.

The many faces of lupus Jean Bolognia Yale School of Medicine, New Haven CT, USA Although four original ARA criteria for systemic lupus erythematosus (LE) involve mucocutaneous surfaces (malar rash, discoid lesions, oral ulcers and photosensitivity), dermatologists know that except for discoid lesions, these findings are rather

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Saturday, 1 September 2018 nonspecific. For example, the most common causes of a malar rash, oral ulcers and photosensitivity are acne rosacea, aphthous stomatitis, and either polymorphous light eruption or photodrug eruption, respectively. Of the three major subtypes of mucocutaneous lupus (acute, subacute, and chronic), it is the subacute form that can be induced by systemic medications, e.g., hydrochlorothiazide, calcium channel blockers and terbinafine. However, drug-induced subacute cutaneous LE needs to be distinguished from drug-induced systemic LE in which pericarditis is common, but cutaneous findings are extremely rare. Additional forms of lupus include the four major types of chronic cutaneous LE – discoid LE, chilblain lupus, lupus panniculitis, and LE tumidus – as well as bullous eruption of LE and Rowell’s syndrome. In patients with cutaneous LE, markers for systemic involvement include hematuria, proteinuria, arthralgias, and a high-titer ANA (>1:320). There are also cutaneous findings that trigger the possibility of the diagnosis of LE and they include small vessel vasculitis, urticarial vasculitis, Degos-like lesions, Raynaud’s phenomenon, proximal nailfold telangiectasias, livedo reticularis, livedoid vasculitis, calcinosis cutis, and non-scarring alopecia.

Improving your cutaneous surgery Glenn D. Goldman UVM Medical Center, Burlington, VT, USA This lecture will provide pearls for improving cutaneous surgery. The presentation expands upon literature findings to improve the outcomes of surgical excision, PDT, laser and injections.

The frequency and spectrum of skin disorders seen in a paediatric outpatient’s clinic in Durban, South Africa Gillian Lawrie University of KwaZulu-Natal, Durban, South Africa Skin disorders are a common problem among children account for a 20-30% of presenting complaints to primary health care clinics. Skin complaints have a large negative impact on patients and care givers quality of life. The spectrum of skin disorders in a general paediatric clinic has been well documented internationally, with inflammatory conditions such as atopic eczema accounting for the majority of skin diseases in developed countries, but infective conditions account for the majority of presentations in developing countries.

Studies reporting the spectrum of skin disease in specialised dermatology clinics have been published in SA however, however none have been conducted in a primary health care setting.

A cross-sectional study was conducted over a 6month period in 2016 in children

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Saturday, 1 September 2018 aged 0-12 years, presenting with new complaints to a paediatric outpatient primary health care clinic in Durban South Africa.

A total of 517 children were included, the most common presenting complaints were upper and lower respiratory tract infections (37.3%), skin conditions (31.1%), diarrhoea (5.6%) and other conditions (25.9%) ranging from behavioural problems to constipation. The most common skin conditions were; infections and infestations (50%), atopic eczema (32.9%) and seborrhoeic dermatitis (4%).

Chronic skin diseases have a large impact on a child’s quality of life, as well as the family, and place large financial demand on the family and state. Health prevention strategies should use this knowledge to focus on the most common skin disorders, and appropriate streamlined management and referral protocols to minimise cost and improve quality of life of patients and care-givers.

Clinical and pathological features of acral melanoma in a South African population: A retrospective study Johann de Wet Division of Dermatology, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa Acral melanoma is a rare subtype of cutaneous melanoma that disproportionately affects skin of colour and carries a poorer prognosis when compared to other melanoma subtypes. The poor prognosis is attributed to late diagnosis and subsequent relative higher Breslow thickness, but also to a biological intrinsic aggressiveness.

Scientific data from the developing world on acral melanoma is limited and a need exists to further characterise the disease in the African population.

A retrospective chart review characterised the demographics, clinical features and histological data of 66 patients diagnosed with acral melanoma between January 2010 and June 2016 at Tygerberg Academic Hospital, Cape Town, Western Cape, South Africa.

Sixty-six acral melanoma patients were identified from the 335 patients who were diagnosed with cutaneous melanoma during the set time frame. The mean age was 61.5 years (SD 12.5). Forty-two (63.6%) of the patients were female and the remainder were male (male / female ratio 1: 1.75). The majority of patients diagnosed with acral melanoma were black (48.5%) and the proportion of acral melanoma within this group was 80%. Fifty-six (84.8%) of acral melanomas were located on the feet and 10 (15.2%) on the hand. The median duration of lesion before diagnosis was 10 months (range 2 to 84) and the mean tumour size was 3.8 cm (SD 2.2) at diagnosis. The mean Breslow thickness of all acral melanomas at diagnosis was 5.2 mm (median 4.2mm, range 0-22). Stage of disease was known in 41 patients.

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Saturday, 1 September 2018 Twenty-three patients (56.1%) had at least stage III disease at diagnosis. Mean Breslow thickness for hand and foot melanomas was 4.9 mm (range 0-22) and 6.9 mm (range 0-13.3) respectively (p= 0.2552). In the black population the mean Breslow thickness was 6.3mm compared to 4.2mm and 4.3mm respectively in the white and coloured population (p=0.178). Patients from outside the Western Cape presented with a mean Breslow thickness of 6.6 mm and patients from the Western Cape with a mean Breslow thickness of 4.9mm (range 0-22) (p= 0.3602).

Acral melanomas accounted for a significant proportion of all cutaneous melanomas diagnosed. Patients presented with an advanced stage of disease at diagnosis and further studies are needed to further investigate the reasons for delayed diagnosis.

Comparing vitamin D levels in adults with autoimmune bullous diseases on longterm oral prednisone with normal healthy controls Bonolo Mushiana UP Dermatology department, Pretoria, South Africa Autoimmune bullous diseases are a group of conditions that are characterized by manifestation of blisters on the skin or mucous membranes due to loss of cell adhesion and the presence of bound and circulating antibodies directed against the cell surface of keratinocytes. Systemic corticosteroids are the mainstay of treatment. They provide the most rapid and effective control of the disease.

Treatment with corticosteroids may contribute to low vitamin D (25 -OH) levels in these patients; therefore, vitamin D and calcium supplementation are essential to reduce the side-effects of long-term oral steroid use. The aim of the study is to determine the level of vitamin D (25-OH) in patients with autoimmune bullous diseases on long-term systemic corticosteroid therapy and compare these levels with a normal healthy control population according to age and gender, to ensure that the patients are adequately supplemented with vitamin D during treatment.

Vitamin D3 levels were analyzed in 29 patients with confirmed autoimmune bullous diseases on long-term oral prednisone. These levels were compared according to age and gender with those of normal healthy control subjects. 3ml of blood was obtained from each participant and sent to a private laboratory within 24 hrs.

Vitamin D3 levels were higher in patients with autoimmune bullous diseases than in the control group for all the different ages and genders. The study demonstrated that the levels of vitamin D3 in patients with autoimmune bullous diseases on prednisone and vitamin D supplementation were higher than those of the normal healthy control group not on any supplementation, confirming the importance of vitamin D supplementation in such patients. It is therefore recommended that vitamin D levels be included as part of monitoring for these patients.

This study was funded by DSSA.

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Saturday, 1 September 2018 Quality of life of adults with autoimmune bullous diseases in Pretoria Tarryn Jacobs University of Pretoria, Pretoria, South Africa Although rare, autoimmune bullous disease (AIBD) has a significant impact on the quality of life (QOL) of patients. There are very few studies that have been done on the QOL of AIBD patients, and thus far there is no published data in Sub-Saharan Africa. In this study, we sought to assess the QOL in patients with AIBD in our population.

We conducted a cross-sectional study on 25 AIBD patients seen at the dermatology department of Steve Biko Academic (SBAH) and Kalafong Hospitals (KH) in Pretoria, South Africa. QOL was evaluated using the RAND 36-Item Health Survey (RAND SF-36) to assess the general health status and the Dermatology Life Quality Index (DLQI) to assess dermatologic-specific aspects.

We evaluated 14 patients with bullous pemphigoid, 7 with pemphigus foliaceus, 3 with pemphigus vulgaris and 1 patient with epidermolysis bullosa aquisita. The average age was 56 ± 18 years and 16 (64%) were female. The median score of the DLQI was 12 ± 7.5, which classified as a “very large effect” on QOL. QOL, as assessed by the Rand SF 36 shows the most affected scales were those of role limitations due to physical health (39), general health (45) and energy/fatigue (48).

AIBD significantly impair the QOL of patients in public hospitals in Pretoria, South Africa. We described a large impact for both the general health and dermatologyspecific QOL aspects. Therefore, for effective and individualised patient care, consideration should be given to the patient’s QOL impairment.

Acne scarring and keloids new approaches Rajendrakumar Singh Private Practice, KwaZulu-Natal, South Africa Acne scarring and keloids are extremely common conditions which plague many patients. While many practitioners still use the older methods, this talk will highlight the new methods that are available.

A comprehensive literature search was done and all the available treatments were analyzed. The newer treatments are being discussed.

Acne scarring and keloids are difficult to treat, however there are revolutionary treatments available to the patient, and better treatments will be found in the future.

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Saturday, 1 September 2018 Tips and tricks in procedural dermatology Robert T Brodell University of Mississippi Medical Center, Jackson, MS, USA; University of Rochester School of Medicine, Rochester, New York, USA As a medical dermatologist in a small town, solo private practice for 27 years, my interest in surgery was rooted in identifying simple, quick, efficient, effective, almost “fail safe” methods to accomplish procedural work in the regular flow of patients.

My patients appreciated saving money when more complex procedures could be avoided and saving time by having all of their problems addressed on the same visit. In my more recent role as chairman of the Department of Dermatology at the University of Mississippi Medical Centre I had the good fortune to work with dermatologists from around the United States and learned more tips and trick.

Approaches that enhance punch biopsy techniques, nail procedures, and suturing tricks will be presented with an emphasis on risks and benefits of each. While work on the skin is amazingly forgiving, caution should be taken when introducing new technique into clinical practice. Understanding the mechanisms behind the technical innovation, working with a preceptor, testing a technique on one or a few lesions, and initially avoiding cosmetically sensitive areas when possible, are all prudent approaches.

Methods: 1. Punch biopsy of porokeratosis1; tense blisters2; lipomas3; and cysts4 2. A small round punch can be used to remove larger oval lesions5 3. Assisted instrument tie for scalp procedures6 Results: • Porokeratosis: Bisecting cornoid lamella simplifies histopathologic diagnosis1 • Tense blisters biopsied properly can provide “salt-split skin-like” direct immunofluorescence findings2 • Minor adjustment to technique allows lipomas to be removed with a punch incision3 • Careful attention to removing wall allows cysts to be removed with punch incision4 • A small round punch can be used to remove larger oval lesions5 • Secure knots can be tied with instrument technique even in hairy scalp6 Conclusions: Medical dermatologists can perform many procedures quickly and efficiently in the flow of patients and maximize diagnostic yield of other procedures using simple tips and tricks.

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Sunday, 2 September 2018 Interesting paediatric dermatology cases seen at tertiary and regional general dermatology clinics in KwaZulu Natal Antoinette Vanessa Chateau University of KwaZulu-Natal, Durban, South Africa Paediatric skin conditions account for approximately 30% of all skin conditions seen in dermatology clinics in Kwa-Zulu Natal. The most common conditions being eczema, various cutaneous infections and vitiligo. Occasionally we encounter unique presentations of common conditions as well as rare intriguing peadiatric skin conditions. A discussion of 10 interesting cases seen at our tertiary and regional general dermatology and paediatric skin clinics will be presented, as well as key points on diagnosis and management. Interesting paediatric dermatology patients from Greys and King Edward VIII hospitals will be reviewed. A discussion of 10 interesting paediatric cases. Key points on diagnosis and management will be discussed.

Onchocerciasis elimination: Are we just scratching the surface?

Michele Murdoch West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom Onchocerciasis is caused by infection with the filarial worm, Onchocerca volvulus, and is one of the eleven neglected tropical diseases recently targeted for elimination

by WHO. Disease manifestations include visual impairment and blindness plus severe pruritus and rashes. The majority of cases occur in 28 countries in subSaharan Africa with smaller foci of infection in Central and Southern America and Yemen. In the Americas, the control programme has used six monthly treatment with ivermectin from the outset with the goal of eliminating onchocerciasis from the region. Colombia was the first country in the world to achieve elimination of transmission of infection in 2013, followed by Ecuador in 2014, Mexico in 2015 and Guatemala in 2016.

Prior to control measures, eye disease was a serious problem in savanna areas of West Africa, but there was less awareness of skin disease.

A multi-country study in seven sites in rainforest areas across tropical Africa, where onchocercal blindness was uncommon, revealed onchocercal skin disease was a significant public health problem which prompted the launch of the African Programme for Onchocerciasis Control (APOC) using annual ivermectin distribution. In 1997 community distribution of ivermectin was introduced, whereby the communities select the drug distributors from among themselves and choose the timing of drug distribution, which has proven to be a highly successful strategy.

It was uncertain whether elimination with ivermectin was feasible in Africa as here the vectors are very efficient and the epidemiology very different with large endemic

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Sunday, 2 September 2018 areas which are often not well defined. The first evidence that onchocerciasis elimination might be feasible in Africa came in 2009 from studies in Mali and Senegal which lead to a paradigm shift with APOC revising its target from disease control to one of elimination. The Expanded Special Project for Neglected Diseases (ESPEN) has now superseded APOC with a target for elimination of onchocerciasis in Africa for 2025. Progress towards elimination of onchocerciasis and resultant impact on onchocercal skin disease will be reviewed.

Spectrum of diseases among patients attending a private dermatology center in Kigali Rwanda Kayitesi Kayitenkore Kigali Dermatology Center, Kigali, Rwanda Rwanda is a small landlocked country located in Eastern Africa. While they were studies examining the epidemiology of skin diseases before the 1994 Genocide of the Tutsi (Van Ecke et al, Bugingo et al), since then publications have been even scarcer (Homeowning et al). Nevertheless, the Rwanda Integrated Health Management System reports skin diseases as seventh in the ten-leading cause of morbidity before physical trauma, diarrhea and eye diseases. The aim of this study was to determine the spectrum of skin diseases seen in a private dermatology center based in Kigali, Rwanda. This retrospective study reviewed and analyzed the electronic health records of patients seen at our clinic between January 2016 and December 2017. Diagnosis was based on clinical findings with complementary biological or histopathological investigations in certain cases. The electronic health records is called Open Clinic and the World Health Organization ICD 10 was used to classify pathologies.

12361 patients consulted between 1/01/2017 and 30/06/2018. The largest age groups were 0-5 years and 30-35 years. Eczema was the first cause of consultation at 19% with atopic eczema contributing 9% and other eczemas 10%. It was followed by acne at 15% and superficial fungal infection 13%. Urticaria came fourth at 6, 6% most of it being papular urticaria. Cheloids constituted 2.6% of causes of consultations while molluscum contagiosum and psoriasis contributed 2% and 1,8% respectively.

Although not generalizable to the whole country, our review gives a rough picture of the epidemiology of skin disease encountered. Since our patients are mostly urban in origin and relatively wealthy compared to the rest of the population, pathologies are not fully representative of the epidemiology of skin diseases seen in Rwanda. Nevertheless, the study reveals a shift from infectious diseases towards inflammatory diseases over the years. A larger survey covering all provinces will allow a better understanding of the burden of skin diseases and set a foundation for the improvement of skin care in our population.

Oral Abstracts

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Sunday, 2 September 2018 Are we clinically missing leprosy in era of elimination?

Neena Khanna Department of Dermatology & Venereology All India Institute of Medical Sciences, New Delhi, India With elimination of leprosy, its diagnosis is becoming challenging.

To determine number of patients with leprosy who were misdiagnosed at presentation and misdiagnoses made in these patients.

We retrospectively reviewed files of leprosy patients (2009-2015) at a tertiary hospital in Delhi, India to determine number of patients with leprosy who were misdiagnosed on presentation and misdiagnoses made in these patients.

Of 1543 files reviewed, 156 (1.01%) patients were misdiagnosed at initial presentation with delay (1-36 months) in institution of antileprosy therapy. Twenty-seven (17.3%) patients, were misdiagnosed at primary health center, 46 (29.5%) by GPs, 34 (21.8%) by non-allopathic physicians, 39 (25%) by dermatologists, 9 (6.4%) by internists and 1 (0.6%) by a surgeon. In 92 (59.0%) patients, delayed diagnosis led to development of disabilities (grade I: 60; grade II: 32). In 112 (71.8%), patient’s prescription did not have a diagnosis. Of 36 patients with a dermatological diagnosis, 22 (14.1%) were diagnosed as fungal infections, 3 as post kala azar leishmaniasis, 2 each as orofacial granulomatosis, granuloma annulare and sarcoidosis and 1 each as erythema annulare centrifugum, erythema nodusum and Sweet’s syndrome (last 2 having erythema nodosum leprosum; ENL). Nine (5.8%) patients with ENL who presented to internist (due to conspicuous constitutional symptoms), 3 were misdiagnosed as lymphoma and 6 as connective tissue disorders. One patient was operated by surgeon with misdiagnosis of nerve tumor.

Leprosy remains a great mimicker and clinicians really need to think of leprosy, even in era of elimination.

Onyiasis: A new African disease Bwanali Jereni Zomba Central Hospital, Zomba, Malawi Two patients presented at clinic with haemorhagic bullae consistent with Onyalai which an acquired form of immune thrombocytopenia is. Clinical presentation, history, physical examiantion, investigations, management and literature search.

Patients suffered from Onyalai. Onyalai is still seen among our patients.

Oral Abstracts

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Sunday, 2 September 2018 Investigation of drought associated scabies outbreak in Ethiopia Wendemagegn Enbiale Yeshaneh Bahirdar University Medicine and Health Science College, Bahirdar, Ethiopia The impact of the2015/2016 drought in Ethiopia attributed to El Niño weather conditions has led to high levels of malnutrition that increased the potential for diseases outbreak. Following a house to house census a detailed study has been done looking at the scabies burden.

A house to house data collection was undertaken to assess the prevalence of scabies.

1125770 people in the 68 hot spot woredas in Amhara Region were surveyed using a simplified tool. A subsequent series of data were collected from two zones and six woredas from 474 participants who had been diagnosed with scabies. This looked at the specificity of scabies diagnosis, age distribution, severity, duration of illness, super infection and other socio-demographic variables as a preparation.

The census has registered 1125770 populations with 379,000 confirmed scabies cases with prevalence ranging from 0.2 to 60.7%. The detailed study has revealed that the specificity of the diagnosis scabies was 98.3%. 75.1% of cases have affected family members, 39% of cases are school aged children and 30 % of them were noted to have bacterial super infection. 11% of the students have dropout from school because of scabies or/and drought. 85% of those dropped out have bacterial super infection.

This article is reporting one of the largest registered scabies cases in the world. The scabies burden in the region is enormous complicated by the nutritional shortage emergency and water scarcity. A coordinated response in case identification and intensified case management wass mandatory to control the epidemic.

Management of chromoblastomycosis: difficulties, challenges and perspectives in developing countries Rapelanoro Rabenja Fahafahantsoa USFR Dermatologie-Rhumatologie, HUJRB Antananarivo, Centred’Infectiologie Charles Mérieux Antananarivo The Chromoblastomycosis is an unknown fungal disease all over the word, even in developing countries. In addition, the lack of proper screening tools as well as therapeutic approach becomes a major challenge in managing this disease.

Researches and local clinical and mycological studies should be conducted in order to set up diagnosing protocols and suitable therapeutic schemes depending on each country’s specificity. Chromoblastomycosis global management includes also improving healthcare accessibility, optimising patients care – from diagnosis to treatment – and effective following-up. The case of Madagascar illustrates well all the awaiting challenges in the management of this disease.

Oral Abstracts

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Sunday, 2 September 2018 So far, there is no well-established therapeutic consensus. Furthermore, developing countries can hardly afford expensive current drugs, not to mention that it is often a hard and longstanding treatment. Prevention and education means should also be further promoted. Future prospects aim at setting up soon an efficient model of management as well as an effective and affordable therapeutic protocol. The challenges are to provide chomoblastomycosis patients with this optimised care which is accessible and efficient over the medium and long term. Given that chromoblastomycosis is officially part of Neglected Tropical Diseases according to WHO, our main goal is to raise awareness among local and international authorities as well as get full support from international donors and aid agencies.

Sensitization profile on allergens of adult patients having atopic and non-atopic diathesis attending K.C.M.C, northern Tanzania Julieth Kalikwendwa Kabagire Ministry of Health, Dar es salaam, Tanzania; Regional Dermatology Training Centre, Moshi, Tanzania There are very few studies in sub Saharan Africa that have addressed the sensitization profile in their general population. In Tanzania there is only one study which targeted women of reproductive age.

The objective of this study was to determine the sensitization profile on allergens of adult patients having atopic and non-atopic diathesis attending KCMC, Northern Tanzania.

Sensitization profile of adult patients was evaluated through skin prick test to fifteen allergens in both atopic and non-atopic patients. Analysis of serum IgE was done for the simple randomly selected one hundred participants for both atopic and non-atopic group. Then comparison of sensitization to allergens was compared to their serum IgE in both atopic and non-atopic groups.

Sensitization to house dust mites (D. pteronysinuss 53.5% and D. farinae 43%) were most common followed by hazel pollen 13%. Serum IgE levels were increased in atopic patients (70%) comparing to the non-atopic (30%).

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Sunday, 2 September 2018 Occupational (& non-occupational) allergy to the chemical preservatives Methylchloroisothiazolinone and Methylisothiazolinone Anna Fourie a.NIOH-NHLS; b.Department of Clinical Microbiology and Infectious Diseases, University of Witwatersrand Methylchloroisothiazolinone/Methylisothiazolinone (MCI/MI) [Kathon] and methylisothiazolinone (MI) are chemical preservatives commonly found in cosmetics, industrial & household products. There is a reported epidemic of allergic reactions to these substances in several countries. In England there has been a 4.1% increase in allergies per annum over a 16 year (1996-2012) period. The Occupational Skin Disease clinic at the NIOH has seen an increase in the number of positive reactions to these chemicals recently.

A retrospective assessment of patients referred to the NIOH Dermatology Clinic between 2006 and 2017 was conducted. Patients with contact dermatitis were patch tested for sensitisation to MCI/MI and/or MI using the European baseline & cosmetic series (Chemotechnique). Frequencies of sensitisation to the allergens (MCI/MI & MI) were calculated using Microsoft Excel.

Prior to 2014, only 3.1% (10/327) of cases had positive patch test reactions which steadily rose to 7% (6/86) of cases post 2014 when allergens were adapted with the concentration of the (MCI/MI) being doubled (from 0.01 to 0.02%) & MI (concentration of 0.2%) introduced as a test on its own in 2015. Occupational patients identified with sensitisation to the chemicals included beauticians, cleaners, a millwright, healthcare workers, a waitress and several workers that either decanted or mixed the chemicals. Patients who were referred because of suspected allergy to cosmetics and self-care products were also identified as being sensitive to the Kathon.

The importance of ensuring that the correct allergen concentration is used for testing to avoid false positive or false negative patch test results.

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Sunday, 2 September 2018 Cutaneous leishmaniasis: A neglected disease in Naivasha District, Rift Valley Province, Kenya Etemesi Beatrice Kakmega County Government, Department of Health, Kakamega, Kenya Cutaneous leishmaniasis is a major health concern and its prevalence is estimated to be 12 million worldwide with an at-risk population of approximately 350 million persons. In Kenya there are several foci of Cutaneous Leishmaniasis, namely in the Rift Valley, Central and Western parts of Kenya. We sought to carry out a survey on the presence of Cutaneous Leishmaniasis in two locations previously reported to have cases within the Rift Valley province in Kenya.

The community was sensitised on the surveillance. Five different schools in the two areas were used as sites for screening. Home visits were also done. Diagnosis was based initially on clinical findings and confirmed histologically in approximately 1/3 (one third) of the cases. One thousand eight hundred and seventy-five (1,875) individuals were examined for evidence of Cutaneous Leishmaniasis. The overall prevalence was found to be 3.89%.

The clinical types of leishmaniasis identified in these areas were Cutaneous, Mucocutaneous and Disseminated Leishmaniasis. These cutaneous presentations varied from papulomatous type to ulcerated and crusted plaques of varying sizes ranging from 0.5cm to 15cm in diameter. The leishmaniaisis lesions (active and scars) were mainly found on the face (103) excluding lips and ears. The other sites affected were; lips-5, ears-5, leg-3 and upper limb-7. Twenty-nine of those with active lesions complained of symptoms, 86.2% complaining of itch while 10.34% had pain and 3.45% photophobia. Leishmaniasis was histologically confirmed in 25 of the 42 biopsies taken.

None of the domesticated animals showed signs of cutaneous leishmaniasis during the home visit although many hyraxes were encountered.

Cutaneous leishmaniasis is a neglected skin disease of public health concern in the Rift Valley Province of Kenya.

Limitation: Not all patients were confirmed to have leishmaniais by histology *Please note that the above abstracts were available at the time of print.

Exhibition Floorplan

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Exhibitors Key Exhibitor AbbVie

Adcock Ingram African Society of Dermatology and Venereology (ASDV)

69 Stand No.

Exhibitor

Stand No.

35 & 36

Galderma

33 & 34

Genop Healthcare

18 & 19

Genop Healthcare - Epimax

58 & 59 14 & 15

41

Table

FotoFinder Systems

32

African Women's Dermatologic Society (AWDS)

Table

Inova Pharmaceuticals

Albinism Society of South Africa (ASSA)

Table

La Roche - Posay

44

Litha Pharma

20

Allergan Pharmaceuticals

31

Lycoderm Laboratories

22

Allergy Foundation South Africa (AFSA)

Table

Aspen Pharmacare Audela Healthcare (ISDIN) Aveeno Bausch + Lomb

55 9,10 & 11 47 & 48 37

Bayer

26 & 27

Beiersdorf (Eucerin)

39 & 40

49

Obagi Medical

38

Pierre Fabre

5

ProActive SA (Pty) Ltd

7

Skinceuticals

46

SkinTECH

43

50

South African Society of Dermatological Surgery (SASDS)

Table

42

Sternlaser

23

Uriage South Africa

13

Vichy

45

BioNike and Dis-Chem

53

BTL Medical SA

56

Cipla Clinisut Cosmetiques De France (Noreva & Mustela)

51

Dark & Lovely

54

Emthunizini Hats

Mixa

Table

52

Dove

29 & 30

South African Dermatology Physician Assistants Society (SADPAS)

Bioderma

Dermatology Society of South Africa (DSSA)

Meda Pharma

Table 6 Table

Essel Products

28

Evolabs

25

Vitiligo Society of South Africa (VSSA) Waldmann Xeroderma Pigmentosum Society and the Skin Cancer Society

Table 8 Table

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Dermatology for Africa 2018