PRESIDENT`S MESSAGE 皮膚科醫師該是走出自己診間的時候了。 我們可以獨善其身，為自己的病患把關，算是不愧於Hippocratis的誓言，所謂「余之唯一目的，為病家 謀福，並檢點吾身，不為種種墮落害人之敗行」。在為國民皮膚健康把關與協助他們追求肌膚之美的同時， 吾輩是否也該積極提供更好的教育資源，讓其他醫界手足一同精進。雖非取代專科醫師訓練制度，若有心汲 取醫術者能有所收穫，亦能在皮膚科醫師引領之下一窺堂奧。 感謝黃柏翰醫師、王銘燦醫師、許乃仁醫師、蔡仁雨醫師及所有參與籌備工作的皮膚科同仁們熱情投 入，精心規劃本次春季學術研討會，追求「Skin Health and Beauty」的最高境界。而本著引領台灣美容醫學 教育、提升其基礎與繼續教育水準的決心，台灣皮膚科醫學會也正式宣告「第一屆臺灣皮膚科美容醫學學術 研討會」的誕生。我們誓言，這兩個會議將提供台灣醫界最先進、深入而全面的皮膚醫學與美容醫學的教育 課程，從皮膚內科學、皮膚外科學、小兒皮膚醫學，到美容皮膚醫學。不但提供與會者最新的知識與技術， 也讓國內皮膚科會議具備與國際同步的視野與願景。二十位國際皮膚醫學專家與首次英國的University of Glasgow的遠距臉部解剖教學的創舉，正是我們與世界同步的註腳。 此外，本次大會體貼而完備的會議規劃，讓與會者有如身在具體而微的美國皮膚科醫學會年會。不願妥 協且堅持理想、創新、宏觀，本來就是皮膚科醫師的特質。在醫術更為精進的同時，也必將以身為皮膚科醫 師為榮。 就從今日, 我們一同開啟皮膚醫學與美容醫學的新頁。 敬祝大會成功!
It is time for dermatologists to step beyond clinics. As physicians who have practiced the art of dermatology in the day-to-day care of patients as well as those in need of aesthetics, we can proudly say that we have stayed true to the Hippocratic oath, “Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption.” In addition to aiding our citizens in their pursuit of skin health and beauty, it is our duty to simultaneously provide improved educational resources, for the collective advancement of the medical community. While the meeting itself cannot replace formal training for our specialty, those who wish to gain insight upon the subject will find it rewarding, as dermatologists lead the exploration towards the profundities of aesthetic medicine. With great pleasure, I would like to welcome you all to the Taiwanese Dermatological Association Spring Meeting 2013 and the 1st Taiwan Dermatology Aesthetic Conference. Through this event, we will share knowledge and experiences that we have harvested over the years, from general dermatology, dermatological surgery, pediatric dermatology to aesthetic dermatology. We have invited twenty honorable speakers from around the globe to give us a state of the art perspective in their respective fields. We have also organized a real-time tele-workshop of facial anatomy with the Clinical Anatomy Skills Centre in the Laboratory of Human Anatomy at the University of Glasgow. This Conference, thoughtfully organized by our committee, promises to offer an experience similar to that of annual meeting of the American Academy of Dermatology. I would like to thank Drs. Po-Han Huang, Ming-Tsan Wang, Nai-Ren Hsu, Ren-Yeu Tsai, and all those involved in organizing this wonderful event, as well as our pursuit of perfection in “Skin Health and Beauty." As persevering, creative and broad-minded dermatologists, we shall take pride in our profession. Today, we shall unfold a new page in our study of dermatology and aesthetic medicine.
Chih-Hsun Yang, M.D. President, Taiwanese Dermatological Association
KAOHSIUNG CITY Facing Taiwan Strait on the west and Bashi Channel on the south, Kaohsiung is a beautiful and modern metropolis located in southern Taiwan as well as the second largest city of this island. Looking down from an airplane, one will see the abundant landscapes of Kaohsiung: the lush Chai Mountain and Banping Mountain, the clear and serene Lotus Pond, and Love River flowing across the city. This subtropical city boasts its brilliant sunshine and gentle breeze from the passionate sea. Be inspired for your visit to Kaohsiung, click here and here to get a taste of the city and its many attractions and highlights. An overview of Kaohsiung as a whole can be found here : www.kcg.gov.tw/EN/Index.aspx
LETTER OF INVITATION 敬愛的皮膚科前輩先進： 身為基層醫師，深知皮膚臨床醫學水準之提升，除了紮實的住院醫師訓練外，廣泛而深入的臨床醫學繼續 教育更為重要。既知以基層醫師需求為出發點的醫學繼續教育課程需求殷切，我等徒有過去十幾二十年參加 過數十次國際會議的經驗，何不自己請纓上陣，期盼辦出理想的學術研討會，讓我們的執業觀念與技術，在 經過這次會議後能更加精進與提升。 皮膚科醫師除了肩負起國內皮膚科臨床工作，照顧國人皮膚健康外，對於共同提升美容醫學之醫療水準， 亦責無旁貸。春季學術研討會作為臨床醫學繼續教育平台，為正式向醫界與臺灣社會展現我們在美容醫學的 專業、宣告我們提供國內最佳美容醫學教育資源的決心，本次將更加關注於皮膚美容醫學議題，除了將會議 主題訂為Skin Health and Beauty，更將同時舉辦「第一屆臺灣皮膚科美容醫學學術研討會」。除將提升國人皮 膚健康與型態美學醫療水準外，也希望導正國內也希望導正國內亂象，讓有志於此新興領域的各界同好能齊 聚一堂進行研習與討論。 會議內容將涵蓋皮膚疾病與美容皮膚醫學，同時段將有多場學術活動。此次會議並將首次與英國 University of Glasgow之解剖研究室連線，進行臉部解剖教學。如此皮膚醫學與美容醫學盛會，在亞洲地區舉 辦誠屬可貴，目前已知將有百位來自港、星、馬、泰與菲國的醫師與會。提升臺灣皮膚科醫學會所主辦的醫 學會議在亞洲的能見度，是我們接辦這次會議的另一個目的。 一個好的學術研討會，除了精采的會議內容外，更需要專業的會議場所。高雄國際會議中心承諾提供舒適 而寬闊的展場---提升會議場地的品質，也是我們志願主辦此次會議的重要目標。 “皮膚科醫師”是我們的品牌。在如此混亂的時代，唯有堅持我們的核心價值，才能凸顯我們的優勢。我 們略盡棉薄之力，只期望拋磚引玉，共同為”皮膚科醫師”這個品牌努力。
Dear colleagues and friends of the TDA, We would like to invite you to the Taiwanese Dermatological Association(TDA) Spring Meeting 2013 and the 1st Taiwan Dermatology Aesthetic Conference (TDAC), which is held on May 4 and 5, 2013, at the International Convention Center, Kaohsiung, Taiwan. The purpose of this meeting is to advance quality dermatologic care and to improve competence and performance in Taiwan. Please accept our invitation to join this active and friendly meeting and give lectures to share your precious experiences with dermatologists here. In keeping with our core mission of "skin health and beauty", we are proud to bring you the updated information for aesthetic dermatology, dermatological surgery, pediatric dermatology and medical dermatology. Join us to witness the next generation of exciting products and equipment as well as cutting-edge procedures and techniques. This will prepare you to better serve patients, and enrich and enhance your overall practice. Kaohsiung is a vibrant city with all of the color, excitement, and rich cultural heritage of a leading modern Asian city. Kaohsiung, a city of glamour, not only has unique features of mountain, sea, river, and port, but also possesses a rich culture and beautiful cityscape. The city sincerely welcomes your visit. Please join us for two days of lively and informative presentations and knowledge exchange about the latest findings of dermatology. We wish you a stimulating and fruitful meeting and an enjoyable stay in Taiwan. Organizing Committee Po-Han Huang, MD, Chair Ren-Yeu Tsai, MD, Vice Chair Ming-Tsan Wang, MD, MSc, MOH, Vice Chair Nai-Ren Hsu, MD, Secretary-Treasurer Taiwanese Dermatological Association Spring Meeting 2013 1st Taiwan Dermatology Aesthetic Conference 6
TABLE OF CONTENTS TABLE OF CONTENTS 理事長的話 PRESIDENT`S MESSAGE
主辦單位的話 LETTER OF INVITATION
籌備委員會 ORGANIZING COMMITTEE
會議緣由 ABOUT TDAC
贊助單位 SUPPORTERS & EXHIBITORS
New This Year
報到需知與出入管制 GENERAL INFORMATION
Taiwanese Dermatological Association
免費接駁巴士 FREE SHUTTLE BUS
會議場所 MEETING VENUE
Tel: 886-2-25185126-7 Fax: 886-2-25185128 Web: http://www.derma.org.tw E-mail: email@example.com
SCIENTIFIC SESSIONS SATURDAY, MAY 4 1.Dinner Symposium
2.Dinner Focus Session
Breakfast Focus Session
Advanced Injection Workshop
Kao Eczema Symposium
Luncheon Symposium and Forum
Adjuvant Therapy in Dermatology Symposium
SUNDAY, MAY 5
乾癬治療指引研討會 協辦3rd Medical Mycology Training Network
民眾健康教育： 皮膚專家健康網：www.drskincare.com.tw 世界乾癬日系列活動 全民防曬月衛教活動
TABLE OF CONTENTS
ORGANIZING COMMITTEE ORGANIZING COMMITTEE
臺灣有超過半數的皮膚科專科醫師在基層執業，他們不但提供了舉世最佳的基層皮膚醫療服務，也運用 最新的醫療技術，造福具有美容醫學需求的民眾。 這將是臺灣首次由基層皮膚科醫師，根據第一線醫師的臨床需求，設計議程與邀請國外貴賓，共 同為提升臺灣臨床醫療品質而舉辦。我們期望在會議籌辦的過程，各位皮膚科先進能不吝提出建議， 讓這次會議能因為專題演講、示範教學與會場展覽，更加提升臺灣皮膚科醫師執業能力。歡迎來函 TDA2013Kaohsiung@gmail.com。 我們選擇由高雄出發，結合許多本地的基層執業醫師的想法與力量，呈現臨床與美容皮膚醫學的最新學 術新知。 謹代表籌備委員會，我們期待並歡迎您在2013年初夏到訪高雄。 臺灣皮膚科醫學會2013年春季學術研討會 第一屆臺灣皮膚科美容醫學學術研討會 籌備委員會 黃柏翰 蔡仁雨 王銘燦 許乃仁 敬 邀
籌備委員會: 主辦單位：臺灣皮膚科醫學會 榮譽顧問：胡俊弘 主任委員：黃柏翰 副主任委員：蔡仁雨、王銘燦 秘書長兼財務長：許乃仁 醫學會理事長：楊志勛 醫學會秘書長：王偉銘 顧問：王正坤、王德華、朱家瑜、吳介山、吳育弘、李婉若、林長熙、張英睿、張雅菁、張雲亭、陳怡如、 陳國熏、黃禎憲、彭賢禮、楊國材、趙曉秋、蔡呈芳、蔡秀欣、 蔡高頌 議程：蔡仁雨、黃柏翰、許漢銘、藍政哲、邱品齊、許修誠 公共關係：王銘燦 會場協調指揮：蔡秀欣 會刊與網站：蔡昌霖、蔡雅敏、黃柏翰 同步口譯與晚會主持：石博宇、朱暐濤、李建儀、許修誠、曾德朋 高爾夫球敘：何宜承、李武諺 飯店住房與交通接送：歐陽韻璇 會務秘書：楊雅之、林佳蓉、楊淑雅、鄭雅方 協辦單位：臺灣海峽兩岸皮膚醫學暨醫學美容交流學會、財團法人臺北市玉泉公益教育基金會
There has been more than half of dermatologists running their own clinics in Taiwan. They offer one of the best dermatology care services in the world for local community. In addition, they are also practicing with newest techniques for patients with aesthetic demands. Local practicing dermatologists are proud to support Kaohsiung to act as host city for the staging of the Taiwanese Dermatological Association Spring Meeting in 2013 and the 1st Taiwan Dermatology Aesthetic Conference (TDAC) to present the latest information on medical and aesthetic dermatology. On behalf of the Organizing committee, we look forward to welcoming you to Kaohsiung in 2013. TDA Spring Meeting 2013 and the 1st TDAC Organizing Committee Po-Han Huang MD, Executive Director, Taiwanese Dermatological Association (Kaohsiung) Ren-Yeu Tsai MD, Associate Professor, Taipei Medical University (Taipei) Ming-Tsan Wang MD MOH, Director, Taiwanese Dermatological Association (Kaohsiung) Nai-Ren Hsu MD, Superintendent, Hsu NR Dermatology (Tainan)
Organizing Committee Organizer: Taiwanese Dermatological Association Honorary Advisor: Chung-Hong David Hu MD FACP Chair: Po-Han Huang MD Vice Chairs: Ren-Yeu Tsai MD, Ming-Tsan Wang MD MOH Secretary-Treasurer: Nai-Ren Hsu MD President of TDA: Chih-Hsun Yang MD Secretary General of TDA: Wei-Ming Wang MD PhD Consultants: Cheng-Kun Wang MD, Tak-Wah Wong MD, Chia-Yu Chu MD PhD, Chieh-Shan Wu MD, Yu-Hung Wu MD, Woan-Ruoh Lee MD PhD, Chrang-Shi Lin MD, Ying-Jui Chang MD PhD, Ya-Ching Chang MD, Yun-Ting Chang MD PhD, Yi-Ju Chen MD PhD, Gwo-Shing Chen MD PhD, Jhen-Sian Huang MD, Hsien-Li Peng MD, Kuo-Chia Yang MD, SheauChiou Chao MD, Tsen-Fang Tsai MD, Hsiou-Hsin Tsai MD, Kao-Sung Tsai MD Scientific Assembly Committee: Ren-Yeu Tsai MD, Po-Han Huang MD, Hamm-Ming Hsu MD MSc, Cheng-Che Eric Lan MD PhD, Pin-Chi Chiu MD EMBA, Hsiu-Cheng Hsu MD LLM Public Relations: Ming-Tsan Wang MD MOH Meeting Coordinator: Hsiou-Hsin Tsai MD Publishing & Website: Dino Tsai MD, Ya-Min Tsai MD, Po-Han Huang MD Simultaneous Interpreting and Party Hosting: Hsiu-Cheng Hsu MD LLM, Jennifer C. Lee MD, Jonathan Te Peng Tseng MD, Po-Yu Shih MD, Thomas Chu, MD Golf Syria: Ji-Chen Ho MD, Wu-Yen Lee MD Hotel and Transportation: Yun-Hsuan Ouyang MD Conference Secretaries: Ya-Chih Yang, Chia-Jung Lin, Shu-Ya Yang, Ya-Fang Cheng Co-organizers: Strait Exchange Academy for Dermatology and Esthetic Medicine, Taiwan , Yu-Chuan Foundation
ABOUT TDAC ABOUT TDAC
美容皮膚醫學，乃是植基於皮膚生理學、皮膚病理學、臨床診斷學、皮膚治療學、皮膚外科學，將科學與 美學結合的產物。由於嚴格的專科醫師訓練制度，讓皮膚科醫師能輕易地診斷皮膚的狀態，再利用最新的治 療技術，完美地與型態美學結合，讓皮膚科專科醫師擁有與其他科別醫師更全面而獨特的增進皮膚的健康與 美感的能力。 然而隨著醫療科技的進展，更精確的評估方法、創新的生物醫材與先進的治療儀器的發明，皮膚科醫師雖 早已能善用自己對於皮膚狀態診治的優勢，提供更好的醫療服務，但臺灣皮膚科醫學會身為國內最大美容醫 學領域之署定專科醫學會，有責無旁貸的義務，提供除了皮膚科醫師以外有志於美容醫學領域的醫界同仁進 修的管道，全面提升臺灣美容醫學水準。除將提升國人皮膚健康與型態美學醫療水準外，也希望導正國內非 專業當道的"醫美亂象"，因此舉辦臺灣皮膚科美容醫學學術研討會，讓有志於此新興領域的各界同好能齊聚一 堂進行研習與討論。 臺灣皮膚科美容醫學學術研討會將提供國際頂尖專家互動交流、現場示範教學、臨床醫學美容醫學兼具的 自由選擇多元教育課程，以提升國內與區域國家皮膚美容醫學水準，貢獻醫學繼續教育，提供臨床研究與專 家經驗的交流園地。
About TADC Aesthetic dermatology is a combination of skin physiology, skin pathology, clinical diagnosis, skin therapeutics and skin surgery. It is a marriage of science and aesthetics. Doctors can easily diagnose the status of skin and its problems due to the intensive and strict training programs for specialized dermatologists. By combining the most advanced therapeutic technique with precise aesthetic concept it allows dermatologists to enhance the health of skin and its beauty. A dermatologist can achieve his/her best skin care medical practice by combining the progress of medical technology along with more precise diagnostic methods, innovative biological medical device and invention of advanced therapeutic equipment. However, Taiwanese Dermatological Association, the largest and prestigious aesthetic medical society in Taiwan, has the obligation to provide the physicians other than dermatologists to pursuit the knowledge of the aesthetic medicine in order to enhance the quality of care to a higher level. Not only do we hope to elevate the health of skin and the aesthetic standard of our people but we also hope to correct the chaos of other non-specialized doctors who are taking charge of most of the aesthetic medicine in Taiwan. Therefore, conducting a Taiwan Dermatology Aesthetic Conference (TDAC) will allow physicians who are interested in this new medical field further learning and discussion. This symposium will provide the best international experts with interactions, live demonstrations and varies choices of clinical aesthetic dermatology learning courses. It is our goal to enhance the standard of our national aesthetic dermatology as well as to contribute to the continuation and the growth of medical education and to become an exchange corner of clinical researches and expert experiences.
TDAC Logo Design Concept
Line : 線條 代表臺灣各地皮膚專科精英 Red Dot : 紅點 臺灣皮膚科美容醫學學術研討會 Vision : 科技 / 美學 / 提升臺灣美容醫學水準
Vision is positioned ourselves as the market leader for aesthetic dermatology and cosmetic procedures. It's characterized as a simple and humble solution to maintaining good health; hopes to bring joy and improve lifestyle.
LOGO Designer Asst Prof Wang I-Hsuan Cindy School of Art, Design and Media, College of Humanities, Arts, & Social Sciences, Nanyang Technological University, Singapore 1.2010年獲7項國際最具指標性視覺設計競賽類大獎 2.亞洲最具影響力設計金獎 3.美國ADC 4.One Show Design 5.德國紅點Reddot 6.德國 iF 7.台灣金蝶獎 Prof Cindy Wang is currently in the School of Art, Design and Media; she joined as an Assistant Professor of Visual Communication in 2007. Cindy holds a BFA from the School of Visual Art and a MA in New York University (NYU), Dept. of Graphic Communication Management & Technology. Cindy's research focuses on use various principles and elements of graphic design, and combining with modern printing techniques to enhance visual communications. One of the key findings of her research was how to use illusions to further stimulate the visual expression of an artwork. The research revolves around the utilization of illusions and modern printing technologies to create new, innovative and unique illustration of visual presentation. On the other hand, Cindy also research on type forms that combines elements of Asia and Western typography is innovative from as Asian perspective and meaningful as bridge between East and West. This fusion typography is gathering tremendous interest across the globe and her work in this area establishes her as a pioneer in this exciting new area of design research. She has been successful in securing research grants to support her work. Cindy's reputation is more and more well known on both international and national level. She has been prolific in publishing five books on her research themes, won numerous international awards and with numerous of exhibitions locally and internationally. All these awards are only honored to highly talented designer from Hong Kong, New York, and Germany. This explains that Cindy's creativity, talents, and ability are recognized throughout the continents of Asia, North America, and Europe. 13
SUPPORTERS & EXHIBITORS SUPPORTERS & EXHIBITORS 鑽石級贊助商 香港商高德美有限公司台灣分公司 台灣愛力根藥品股份有限公司 海喬國際股份有限公司 巴爾桑波有限公司 Solta Medical(恆旺國際有限公司) 愛迪亞生醫股份有限公司 萊亞實業股份有限公司
銅級贊助商 賽諾菲股份有限公司 惠民製藥股份有限公司 創越醫學美容有限公司 慶安生醫股份有限公司 杏輝藥品工業股份有限公司 凱安藥業股份有限公司 美康生物科技有限公司 奇瑩國際有限公司 高一藥品股份有限公司 優擎科技有限公司 澳洲意高大藥廠 龍生藥品股份有限公司 晨欣國際有限公司
白金級贊助商 嬌生股份有限公司 德瑪凱股份有限公司 沃醫學有限公司 曜亞國際股份有限公司 膠原科技股份有限公司 新加坡商莫氏亞太有限公司台灣分公司 花王(台灣)股份有限公司
一般贊助商 歐強國際有限公司 衡奕精密工業股份有限公司 服杏企業有限公司 冠群儀器有限公司 永英有限公司 台灣菁萃生技股份有限公司 寶齡富錦生技股份公司 綺麗生技有限公司 泰合生技 德實科技有限公司 拓霖企業股份有限公司
金級贊助商 台灣萊雅股份有限公司 香港商英維達有限公司台灣分公司 友華生技醫藥股份有限公司 裕利股份有限公司 博而美國際股份有限公司 八億實業股份有限公司 妮傲絲翠股份有限公司 美吾華股份有限公司 銀級贊助商 聯發生技美學有限公司 偉業醫療儀器股份有限公司 台灣田邊製藥股份有限公司
NEW THIS YEAR NEW THIS YEAR 會議資訊： 1.首次由基層皮膚科醫師組織籌辦會議 2.舉辦第一屆台灣皮膚科美容 學會議 3.於國際會議中心與其會展場地舉辦會議 4.提供其他國家年輕皮膚科醫師參加此次會議之獎助計畫 5.重要課程口譯 6.與大師有約晚宴 7.前往鄰國會議發送海報 8.發文邀請鄰國友會參與，並介紹議程 專題演講、教學與論壇： 1.會前會提供更多教學課程 2.全日大會演講: What's New in 2013 3.主題式專題研討會，避免會員往來奔波不同會議場地 4.由國際知名專家共同主持專題研討會與論壇 5.現場示範教學，即時互動 6.首次與英國University of Glasgow解剖研究室連線，進行現場國際轉播之臉部解剖課程 7. 注射醫學課程由多位國際知名講者共同進行演講教學 8. 醫事法律論壇: 法學教授、醫事法律師、皮膚科醫師(醫療糾紛調解委員、具法學碩士學位之皮膚科醫師) 9.所有演講廳均舉行午餐時段學術研討會 網站及會議相關內容： 1.會議網站半年前上線，隨時更新 2.線上信用卡繳費註冊 3.會場與飯店間全日接駁車接送 4.皮膚科護理師、諮詢師、技術員與醫師助理訓練課程5.讓所有與會醫師對於會議內容進行評核 6.非會員識別證刷卡進出，取得學分證明 7.嚴格門禁管制，限制未繳參加費者進入 8.公車車身廣告，塑造主辦城市之會議意象 9.晚宴採雞尾酒會式自助餐點方式舉辦，與會嘉賓可端盤優雅用餐，或與同業好友敘舊
NEW THIS YEAR
What's New in 2013 Live Demo to Improve Skills Cadaver Live Broadcasting Conference grants for young international dermatologists
GENERAL INFORMATION GENERAL INFORMATION 報名截止日: 1.早鳥優惠價報名截止：即日起至4/7止 2.一般參加費報名截止：4/21止 3.4/22起不開放報名，若欲參加者請至會場直接報名。
參加人員身分依識別證顏色區分如下: 一般與會醫師(會員、準會員、非會員醫師) 眷屬(會員/準會員的配偶) 貴賓 會員院所內護理師與醫師助理 (部分課程限醫師參加，恕不開放)
報名所需文件 (線上報名請上傳圖檔): 1.非會員(包括國內非皮膚科醫師、非本國之皮膚科 與非皮膚科醫師)：醫師證書或專科醫師證書，現場 報名請出示身份證或護照。 2.會員服務院所之護理人員與醫師助理：服務院所之 在職證明書(須含臺灣皮膚科醫學會會員職章及院所 章)。現場報名請同時出示身分證、在職證明正本。
廠商(每位費用新台幣貳佰元整，相關事項請依 據主辦單位的電子郵件通知辦理) 工作人員 用餐須知: 大會迎賓晚宴訂於五月四日下午五點三十分至 晚間七點，地點位於一樓展場大廳中央。晚宴後 (19:00~21:00)，學術演講緊接著登場。(詳情可參閱 交誼活動) 五月五日午餐時間，除了有四場學術午餐活動同 時進行外(詳情請見會議議程)，本次特於大會會場 五樓增設用餐交誼專區，可同時容納600人以上用 餐。
報到作業事項: 1.因申請衛生署美容醫學學分認證，限使用身份證 進行報到作業。請務必攜帶您的身份證至報到櫃台 辦理報到手續。 2. 5/4 報到時間 : 16:00~21:00 3. 5/5 報到時間 : 08:00~15:00 4.報到地點：高雄國際會議中心一樓大會報到櫃檯。
退費: 1.因辦理會議之必要成本，若為個人因素不克前往 會議者，恕不退費。 2.若因天災等不可抗力因素取消會議，已繳費之與會 者，將由主辦單位 臺灣皮膚科醫學會辦理全額退費。
出入管制: 出入會場一律配掛識別證。 與會者依身份別與是 否預訂活動於進入各講堂或活動地點前，以識別證 刷卡確認身份，始得進入。
大會禁止事項: 演講進行時，全程禁止錄影、攝影、錄音。 會議設備: 會議期間，開放Wi-Fi免費無線上網。
Welcome Reception and Gala Dinner 2013 SATURDAY, MAY 4 PM17:30~19:00 Exhibit Hall
The Welcome Reception will be held at the ICCK after the Opening Ceremony.
皮膚科專科繼續教育積分: 1.5/4(六)會前會(Pre-conference)：皮膚科繼續教育積分四點 2.5/4~5(六、日)春季會：皮膚科繼續教育積分二十四點 醫學倫理繼續教育課程(醫療相關法規)積分：3.6 學分 台灣整形外科醫學會繼續教育積分：15分 臺灣護理學會繼續教育積分： 1.護理師、諮詢師與醫師助理訓練課程 (TC)：2.8小時 2.Plenary Lectures (PL)申請中 3.KAO Eczema Symposium (ES)申請中 4.Lasers Symposium (LS)申請中 衛生署美容醫學學分及各項繼續教育學分: 各項繼續教育學分： 1.配合衛生署美容醫學學分認證相關規定，各講堂出入均須刷卡紀錄時數。 2.參加證明需於會後上網填寫課後問卷完成後，會議當日刷卡紀錄累計時數始得有效認證。 美容醫學教育訓練聯合委員會認證時數：
5/4 19:00-21:00 Dinner Focus Session (DS2) How to Start and Succeed in Injection Jobs
5/5 08:20-08:50 Victory Eight Breakfast Focus Session (BS) Effectiveness of Mono-polar Micro-needling RF in Skin Tightening
5/5 10:40-11:20 What's New and Nest in Laser in 2013 (PL4)
5/5 09:00-16:30 Advanced Injection Workshop (WS)
針劑注射治療 上午3小時、 下午3小時
5/5 13:30-17:00 Lasers Symposium (LS)
5/5 12:15-13:15 Luncheon Symposium (LCS4) Volumetric Full-facial Reshaping: Expanding the Use of Radiesse to Restore Youthful Fullness to the Face
GENERAL INFORMATION GENERAL INFORMATION General Information
Welcome to TDA Spring Meeting 2013 and TDAC! We are here to assist you through your time at the conference and have assembled some important information for you. Please register before attending all sessions. Attendees without registration badges will not be granted entry and to sessions. Pre-registration is strongly suggested as space is limited. Those who have not completed advanced registration before the registration web page closed may register for the meeting at the On-Site Registration Desk. The registration area will be located on the first floor of the International Convention CenterKaohsiung (ICCK) the and will be open during the following hours: Saturday, May 4 16:00-21:00 Sunday,May 5 8:00-15:00 Photo identification will be required.
The official languages of Spring Meeting 2013 are Chinese and English. All aesthetic lectures of TDAC are in English.
Technical Exhibits the will be located at the lobby and before the entrance to in the Exhibit Hall at ICCK. Admittance into the Technical Exhibit Hall is limited to attendees only. Infants and children under the age of 16 will NOT be admitted into the Technical Exhibit Hall under any circumstances. This policy has been created for the safety of the children of TDA member and guests. Your support and compliance are appreciated.
Lunch and Dinner
The Welcome Reception and Networking Dinner will be held in the Exhibit Hall of KICC from 17:30 to 19:00 on May 4. There will be two scientific sessions on the 3rd floor right after this activity. In addition to three luncheon symposia and one luncheon forum during the lunch time on May 5, the participants may network with peers and enjoy Chinese lunch boxes in the dining area on the 5th floor from 12:00 to 14:00. Vegetarian lunch boxes are also available. Please book in advance at Registration Desk.
Speaker Ready Room
The Speaker Ready Room will be located on the second floor at ICCK and will be open during the meeting.
No Alcoholic Beverage and Smoking.No camera and Video Recording.
Free Wi-Fi Service
Wi-Fi service will be free and available at ICCK during the meeting.
The Organizing Committee and staff of Taiwan Dermatological Association administer the meeting. For further information, please feel free to contact the Office of TDA by Phone at +886-2-25185126 E-mail at TDA2013Kaohsiung@gmail.com 18
FREE SHUTTLE BUS FREE SHUTTLE BUS
接駁時間 Time： 5/4 → PM 04:00 ~ PM 10:00 5/5 → AM 07:00 ~ PM 06:00 大會免費接駁車：由會場出發，僅停靠國賓及福容飯 店，尖峰時段10分發一車，離峰時段20-30分發一車
Free shuttle transportation departs from ICCK, and stops at Ambassador Hotel and Fullon Hotel At rush hours, a bus departs every 10 minutes. At regular hours, a bus departs every 20-30 minutes.
接駁路線 Routes： ICCK →
國賓大飯店Ambassador Kaohsiung →
福容大飯店FULLON Hotel, Kaohsiung →ICCK
MEETING VENUE MEETING VENUE
「高雄國際會議中心（ICCK, International Convention Center Kaohsiung）」於2012年10月正式開幕，為 台北以外少有的會議場地。 本次會議選擇在此，位在高雄舊市中心鹽埕區，除了緊臨愛河，舊高雄最豐富的人文風情近在咫尺，懷 舊建築、市井美食，等著你來品味繁華落盡卻又正在重生中的打狗榮町。 鹽埕區有許多傳統商家與產業聚落，如銀樓飾品業、傳統小吃業等，為高雄最具人文歷史特色的行政 區。緊鄰高雄市立歷史博物館與高雄音樂館，面對廣闊的仁愛公園和愛河徒步區。駁2藝術特區、真愛碼頭、 香蕉碼頭、傳統小吃店及特色商店都在步行15分鐘的範圍內。 交通方式 高鐵＞搭乘高鐵至左營站→轉乘捷運至美麗島站換橘線→鹽埕埔站02號出口→步行約3至5分鐘即可抵達 火車＞搭乘火車至高雄火車站→轉乘捷運至美麗島站換橘線→鹽埕埔站02號出口→步行約3至5分鐘即可抵達 捷運＞橘線鹽埕埔站02號出口→步行約3至5分鐘即可抵達 市區公車＞歷史博物館0南(單邊停靠)、0北(單邊停靠)、11、25、33、56、60、76、77、82、建國幹線、91、 214、219、248
The International Convention Center, Kaohsiung (ICCK) is regarded as the only foremost conference venue outside Taipei. Positioned in the very heart of the old city center, it is convenient to explore during your visit. From the registration, exhibition and banqueting areas to the outstanding main auditorium, the ICCK offers the perfect combination of advanced technical facilities and professional service across a broad spectrum of events, making it an excellent venue to host TDA Spring Meeting 2013. •Car : Exit National Highway 1 at Zhongshen Interchange. Estimated travel time: 20 minutes. •High Speed Rail : From Zuoying station, take KRT to Yanchengpu station exit2. Estimated travel time: 30 minutes. •Train : From Kaohsiung station, transfer for KRT to Yanchengpu station exit2. Estimated travel time: 15 minutes. •Kaohsiung Rapid Train (KRT) : From Yanchengpu station exit 2, turn right and walk along with Dayong Rd. approximately 3 minutes.
逃 生 梯
逃 生 梯
前 往 三 樓 會 議
用餐休息區 餐 點 區
餐 點 區
前 往 三 樓 會 議
逃生梯 廠商貨物卸貨 入口處
出入口 管制 出入口 管制
B門廳 貨物裝卸區 空調室
C門廳 女廁B 無障礙廁所
401會議室 A門廳 空調室 秘書室 排煙室
此門不開放 儲藏室 B門廳
SCIENTIFIC SESSIONS Breakfast Focus Session Plenary Lectures Advanced Injection Workshop Hair Symposium Kao Eczema Symposium Luncheon Symposium and Forum Lasers Symposium Adjuvant Therapy in Dermatology Symposium 護理師、諮詢師與醫師助理訓練課程
SCIENTIFIC SESSIONS SATURDAY, MAY 4 Dinner Symposium
Sat. May 4, 10:00~17:40 DS1 “What I Do”
A rational approach to the diagnosis of skin diseases
Han-Nan Liu, MD
Director Chung-Hong David Hu, MD, FACP Speakers Hsien-Ching Chiu , MD Greg Goodman, MBBS Han-Nan Liu , MD Jerry Shapiro, MD
Steps for making clinical diagnosis of skin diseases 1.Make skin diseases look familiar to you: A.Learn from textbooks (classical cases) B.Case reports from Journal (rare cases) C.Join CPC D.Learn the skills of morphologic diagnosis E.Take advantage of any simple bed-side techniques such as Tzank’s smear, dermoscope, etc.
What We Did in Two Cases Hsien-Ching Chiu , MD
2.Skin diseases look familiar, but there is something weird: Examples: A.Malar rash in an old lady. B.Severe acne in an old man. C.Severe seborrheic dermatitis in a young man 3.Skin diseases look unfamiliar to you—your chance to stand out from other dermatologists A.Based on possible pathologic changes B.Consider the possible diagnosis systematically, such as using mnemonics technique (e.g. VITAMIN D )
I will present what we did in diagnosis or management in two cases. The first case is a female patient diagnosed with dystrophic epidermolysis bullosa. She had had skin lesions since early childhood and had been hospitalized yearly for wound care and treatment of iron deficiency anemia. In her age of 48 years, the first squamous cell carcinoma appeared on the back. Thereafter, more than 10 primary SCC developed on the back and scalp in a short period of months. The second case is a 55-year-old female who presented with a 3-month history of erythematous papules and plaques on the nasal bridge. Histopathological examination revealed granulomatous inflammation. She had been treated with various medications under a wandering diagnosis between infection and sarcoidosis without a significant improvement. The second biopsy performed 2 years later also revealed non-caseating granulomatous inflammation, and cultures for common bacteria, fungi and mycobacteria were all negative. She was treated with intralesional steroid and later oral steroid, which led to a significant improvement of the skin lesions. However, a new lesion developed after a 7-month tapering course of prednisolone. The third biopsy showed the similar histopathological change, but the culture grew Mycobacterium gordonae. The skin lesions resolved completely after a 4-month treatment with rifampin, ethambutol and ciprofloxacin, and there has been no recurrence.
Networking Welcome Reception May 4, 17:30~19:00 @ Exhibit Hall Join us in the exhibit hall for the dinner buffet with our guests and exhibitors.
SCIENTIFIC SESSIONS SATURDAY, MAY 4 Dinner Focus Session
Don't Miss Cadaver Live Broadcasting from University of Glasgow!
Sat. May 4, 19:00~21:00 DS2
How to Start and Succeed in Injection Jobs
May 5, 15:30~17:00 @ Exhibit Hall
Speaker Yates Yen-Yu Chao, MD Moderator Ying-Jui Chang, MD, PhD
LEARNING OBJECTIVES – Injectables Overview(Neuromodulator, Collagen, HA, CaHA, PLLA, Autologous Fat) – Applied Facial Anatomy – Beauty Concepts for Injectables – Techniques of Different Fillers Injection – Calcium Hydroxylapatite – Pearls of Success – Real Patients Assessments – Cases Review – Controversies in Injectables – Complications of Injectables – Q&A
The premium clinical anatomy training from the world leading center, the Clinical Anatomy Skills Centre(CACS) from the Royal College of Physicians and Surgeons of Glasgow and the University of Glasgow, is a designed to provide innovative and challenging education and training for physicians, surgeons, dentists and other allied health professionals. It is the newest of a handful of UK centres equipped to provide cadaveric skills training. CASC has been purpose built with the highest specification equipment available today and offers an unsurpassed level of training. Professionals trained at CASC are at the forefront of a constantly changing occupation and capable of delivering the highest standards of care to their patients.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Breakfast Focus Session
Sun. May 5, 8:20~8:50 BS
Effectiveness of Mono-polar Microneedling RF in Skin Tightening
學會於會議籌備期間發文至 亞洲各國皮膚科醫學會， 告知會議資訊，並邀請參加本次盛會。
Speaker Tae-Heung Kim, MD, PhD Moderator Chao-Hsing Kao, MD, PhD
Most aesthetic equipments for skin tightening and lifting are based on the thermal effect sparing epidermis. By heating and denaturating collagen fibers in dermis, dermal remodelling occurs and old dermis is replaced by newly synthesized collagen fibers. To spare epidermis, longer duration of laser lights (selective photothermolysis), specially designed cooling devices to protect skin, or direct delivary of energy by inserting device... etc are utilized. Radiofrequency (RF) is better for rejuvenation of Asian skin because it does not use chromophore as a target. NAR (non-ablative rejuvenation) including monopolar RF or bipolar RF with light energy source is still one of the main therapeutic tool for rejuvenation or skin tightening. Fractional RF, another device combining RF and fractional treatment ideation, is recently introduced. It spares epidermis by inserting insulated needles and delivers very high RF energy directly to dermal collagen fibers. Intracel, the first fractional RF device, is equipped with various tips and energy mode, and permits a lot of new trials of treatments. Continuous efforts by users and manufacturer permits to get better therapeutic results, and it is still in its evolution. Suggested mechanisms of the treatment, various trials to improve therapeutic results, and combination of other treatments will be discussed.
皮膚科醫學會廣編稿A4_O.pdf 1 2013/4/22 上午 10:36:02
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Plenary Lectures
Sun. May 5, 8:40~14:50 PL1
Speakers Ronald Moy, MD Steven Feldman, MD, PhD Adelaide Hebert, MD Henry Chan, MD, PhD Henry Chan, MD, PhD Brian Zelickson, MD WenChieh Chen, MD, PhD Ching-Chi Chi, MD, PhD
Speaker Ronald Moy, MD Moderator Hsin-Su Yu, MD, PhD
Meet the President of TDA
New technology and new techniques has advanced dermatologic surgery. New laser resurfacing procedures has greatly decreased complications and made laser resurfacing easier for patients. Volume and filling procedures has improved with fat/stem cell and poly lactic acid injections New fillers and new techniques have improving cosmetic results to improve eye bags and fine wrinkles. New neuromodulators and radiofrequency devices have improved treatment of glabellar, crows feet and forehead wrinkles. New ways to tighten skin include radio frequency devices, ultrasound devices, laser lipolysis and human growth factor creams that tighten skin. New surgical techniques allow face lifting and neck lifting to be performed under local anesthesia with improved cosmetic results. New resurfacing technologies, new fillers and new ways to tighten skin has advanced cosmetic dermatologic surgery
Chih-Hsiun Yang, MD
Opening Addresses Directors and Chiefs of Health Authorities
What’s New and Next in Dermatological Surgery in 2013 / Ronald Moy, MD
What’s New in Psoriasis and Biologics in 2013 / Steven Feldman, MD, PhD
What’s New and Next in Dermatological Surgery in 2013
PL3 What’s New in Pediatric Dermatology 10:00 in 2013 / Adelaide Hebert, MD PL4 What’s New and Next in Lasers in 10:40 2013 / Henry Chan, MD, PhD PL5 What’s New and Next in Aesthetic 11:20 Dermatology in 2013 Part 1 / Brian Zelickson, MD PL6 What’s New in Acne and Rosacea in 13:30 2013 / WenChieh Chen, MD, PhD PL7 What’s New in Evidence-based Medicine 14:10 in 2013 / Ching-Chi Chi, MD, PhD
What’s New in Psoriasis and Biologics in 2013
What’s New in Pediatric Dermatology in 2013
Speaker Steven Feldman, MD, PhD Moderator Ji-Chen Ho, MD
Speaker Adelaide Hebert, MD Moderator Chong-Hsing Chang, MD, PhD
Psoriasis can be frustrating for patients and for dermatologists, but new advances have made treatment far more rewarding. For patients with limited psoriasis, adherence is a critical issue that must be addressed. Poor adherence causes treatment failure and “tachyphylaxis.” Topical treatments work well when dermatologists use tools-- like building trust, shortening the time horizon, choosing easy to use treatments, and others-- to get patients to use their medications. For patients with more severe disease, biologic treatments offer more potent and safer treatment options. Recent 5-year data on ustekinumab showed an excellent safety profile. Between promoting better adherence and using biological treatment when needed, we can achieve better psoriasis treatment options.
The arena of pediatric dermatology continues to expand with greater understanding of the molecular basis of disease, cutaneous infections and infestations. Additionally, genetic disorders are becoming increasingly well understood and have begun to be treated based on biologic pathways . This discussion will encompass many of the newest discoveries and publications within the field of pediatric dermatology. This overview should provide an update of the latest advances within this emerging area of dermatology.
◎ What's New in 2013? ◎ May 5, 8:40~15:00@Room 303B ◎ Join top experts for a rapid-fire session on the hottest trends in dermatology for 2013.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Plenary Lectures
Sun. May 5, 8:40~14:50 PL4
What’s New and Next in Lasers in 2013
What’s New and Next in Aesthetic Dermatology in 2013 Part 1
Speaker Brian Zelickson, MD Moderator Ying-Chin Wu, MD
Speaker Henry Chan, MD, PhD Moderator Heng-Leong Chan, MD
Keywords: CoolSculpting, cryolipolysis, body contouring, injectable lipolysis, neuromodulators, Botox alternatives, topical Botox, cryo denervation, focused cold therapy, tattoo removal, perfluorodecalin, PFD patch, R-20 method Introduction The aesthetic dermatology industry continues to grow rapidly as consumers seek the newest methods to reduce the signs of aging. Aesthetic procedures are gaining popularity and various new technologies are available to rejuvenate faces and contour bodies. This presentation will review the latest advancements in non-invasive and minimally-invasive fat reduction, including CoolSculpting®, the only FDA-cleared non-invasive procedure to safely and effectively eliminate localized fat by cooling. The newest advancements in tattoo removal, injectable lipolysis, and neuromodulators will be shared. Part 1: Minimally-Invasive Fat Removal, Botox Alternatives, and Advances in Tattoo Removal The demand for neuromodulators has exploded since Botulinum Toxin Type A (BoNT-A) injections were first shown to reduce the appearance of moderate to severe facial rhytids. Since 2000, the number of injectable neurotoxin procedures has grown 621%; in 2011, nearly 6 million BoNT-A injections were performed in the US (ASPS survey, 2011). Clearly, there is a huge market for neuromodulator injectables and consequently, there is a significant opportunity for alternatives to address patients that are needlephobic or averse to introducing neurotoxins into their bodies. Transcutaneous delivery of BoNT-A has been clinically studied and the mechanism of transport will be explained. Topical BoNT-A was found to have a strong safety profile with clear dose dependence and an absence of dose-related adverse events. Significant efficacy was found with results similar to injectable Botox. In addition to topical BoNT-A, a non-toxic neuromodulator was also developed. Cold-induced neuromodulation has been shown to reduce muscle contractility and thus, reduce 40
the appearance of dynamic rhytids. By applying precisely-controlled cold-induced neuromodulation to targeted nerves, specific facial muscles can be relaxed. Cooling technology is a safe and established method of neuromodulation since the 1860â€™s and the novel application of focused cold therapy for temporary, reversible reduction of dynamic rhytids is a promising alternative to neurotoxin-averse patients.
Whatâ€™s New in Acne and Rosacea in 2013
Speaker WenChieh Chen, MD, PhD Moderator Moderator: Han-Nan Liu, MD
Some important clinically relevant findings in acne and rosacea published from 2010 to date will be summarized and discussed in the following presentation. Omitted is the management of acne scars as well as laser treatment. Basic research: A novel in vitro model is described to efficiently culture isolated primary human sebocytes without transformation in explants containing fibronectin.
Laser tattoo removal is an expensive, time-intensive process with frequently sub-optimal results. A new laser tattoo removal protocol has been developed which produces optimal results in a single treatment session. The R-20 PFD patch method utilizes perfluorodecalin, an inert, non-volatile liquid which provides a physical barrier to gases. PFD gel can be loaded into a clear, sterile, single-use patch to block debris and permit multiple laser passes a few minutes apart. In the R-20 PFD patch method, the 1064 nm Q-switched Nd-YAG laser is used with 4 passes spaced 20 minutes apart, producing optimal tattoo removal at significantly reduced time and cost.
Epidemiology: In American children, Caucasian has the highest prevalence of acne, followed by African American then Asian. In women (mean age= 33-39 years), however, the rate is higher in African American and Hispanic women, while in Asian women inflammatory acne is more prevalent than comedonal acne. In China, women with adult acne are more commonly of the late-onset than the persistent type. Moderate to severe acne is more closely associated with family inheritance than with milk consumption. Smoking exerts no influence on the severity of acne but can promote adult acne and formation of comedonal acne. In rosacea, a significantly reduced relative risk is observed among current smokers while alcohol consumption is associated with a marginal risk increase. Clinical manifestations and comorbidities: Acne inversa involves more axilla and upper anterior torso in women but more perineal/perianal regions in men. Metabolic syndromes occur in a disproportionately high percentage of young patients with acne inversa. Patients with acne inversa are prone to develop more pronounced metabolic syndromes. It remains to be determined whether pyoderma gangrenosumacne-suppurative hidradenitis (PASH) syndrome and pyogenic arthritis-pyoderma gangrenosumacne (PAPA) syndrome are two distinct entities or a spectrum within the same disease as well as their therapeutic responses to interleukin-1Ă&#x; blockade. Propionibacterium acnes is identified to be the most prevalent bacterium in the prostate and in men with benign prostatic hyperplasia. Prospective studies are needed to examine the hypothesis of its pathogenic
Last, fat removal is an aesthetic dermatology procedure in high demand. While liposuction remains the gold standard for body sculpting, patients now have numerous minimally-invasive options. Compared to liposuction procedures in 2012, there were more than 6 times as many non- and minimally-invasive body contouring procedures performed (ASDS survey, 2012). One exciting minimally-invasive fat removal technique is injectable lipolysis, specifically the ATX-101 drug developed to selectively target adipocytes. This adipolytic therapy has been effective for minimally-invasive reduction of small volumes of fat, such as in the submental region. Results from a placebo-controlled, randomized, double-blind, international, multi-center Phase 2A clinical trial will be shared. ATX-101 was injected into submental subcutaneous fat in 4 treatment sessions spaced 4 weeks apart. Based upon physician and study subject ratings, the subcutaneous fat reduction was statistically significant and clinically meaningful. Phase 2B and Phase 3 studies are underway, but preliminary results indicate a marked reduction in fat without resultant skin laxity, drug-related adverse events, or systemic effects. ATX-101 injectable lipolysis is shown to be a safe and effective minimally-invasive fat reduction technique. 41
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Plenary Lectures
Sun. May 5, 8:40~14:50 role in prostate cancer. The odds of developing selfreported pharyngitis is more than three times baseline in patients receiving oral antibiotics for acne vs the odds for those not treated with oral antibiotics. On the other hand, the prolonged use of antibiotics from the tetracycline class to treat acne lowers the prevalence of colonization by Staphylococcus aureus without an increase in the resistance to the tetracycline antibiotics. A significant association between severe acne and suicidal ideation is observed in both genders of adolescents aged 18-19 years in Norwegian. A Swedish study shows an increased risk of attempted suicide up to six months after the end of treatment with oral isotretinoin, but an additional risk due to the treatment itself cannot be established. An increase in the risk of inflammatory bowel diseases (ulcerative colitis or Crohn’s disease) associated with use of isotretinoin cannot be confirmed.
moderate to severe acne, but optimal regimens to reach long-term remission remain to be determined. Modern combined oral contraceptives are effective in treatment of mild to moderate acne but differences in the comparative effectiveness of preparations containing varying progestin types and dosages are less clear. Compounds containing chlormadinone acetate or cyproterone acetat demonstrate the best evidencebased therapeutic efficacy. In women with polycystic ovary syndrome simvastatin is shown to be as effective as metformin in reducing acne scores after 6-month treatment. Epigallocatechin-3-gallate can reduce sebum synthesis, suppress inflammation, induce cytotoxicity in cultured SEB-1 sebocytes and decreases the viability of Propionibacterium acnes, furthermore demonstrating great efficacy and tolerability in treating acne in an 8-week randomized, split-face, clinical trial. In mouse skin, inhibitors of the enzyme stearoyl-CoA desaturase 1 are shown to rapidly induce pronounced atrophy of sebaceous glands after topical application in a dose- and time-dependent manner. Antagonists of melanocortin receptor 1 and 5 display a dosedependent inhibition on sebum-specific lipid production, size of sebaceous glands and expression of the sebaceous differentiation marker. There are limited well-designed, adequately powered randomized controlled trials for rosacea therapy. Topical metronidazole and azelaic acid appear to be effective and safe for papulopustular rosacea. There is evidence that low-dose doxycycline is beneficial as well and with fewer adverse effects. Once-daily 0.5% gel of brimonidine tartrate, a highly selective α²-adrenergic receptor agonist with vasoconstrictive activity, is well tolerated and provides significantly greater efficacy than vehicle for the treatment of moderate to severe erythema of rosacea. Substantial clinical improvement of Morbihan disease is demonstrated with longterm (10-24 months) high-dose oral isotretinoin at cumulative doses of 170-491 mg/kg.
Pa t h o g e n e s i s : A d i s t i n c t s u b p o p u l a t i o n o f Propionibacterium acnes (division I-1, epidemic ST18) is significantly associated with moderate to severe acne. Overactivation of the mammalian target of rapamycin complex 1-sterol regulatory element-binding protein (mTORC1-SREBP) signaling pathway is proposed to mediate acne induced by hyperglycemic, insulinotropic, leucine-rich Western nutrition. Aryl hydrocarbon receptor (AhR), the receptor of dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin; TCDD), is expressed in sebocytes. Treatment with TCDD in vitro/ex vivo will suppress sebaceous differentiation and induce atrophy of sebaceous glands and their switch to keratinocyte-like differentiation, leading to the cystic hamartoma formation in chloracne. Mutations resulting in haploinsufficiency of the γ-secretase genes presenilin-1, presenilin enhancer-2, and nicastrin, are found in a subset of patients with autosomaldominant familial hidradenitis suppurativa (acne inversa), implicating the γ-secretase–Notch pathway in the molecular pathogenesis. Growing evidence shows that neuroinflammatory mediators and their receptors are involved in rosacea. Dysregulation of “transient receptor potential ion channels-vanilloid type” also expressed by nonneuronal cells may be critically involved in the initiation and/or development of rosacea. Treatment: New evidence shows a low-dose oral isotretinoin at 0.1-0.3 mg/kg/day for 6 months may be as effective as higher doses in the treatment of 42
SCIENTIFIC SESSIONS SUNDAY, MAY 5 FORUM
Sun. May 5, 15:00~16:30 PL7
What’s New in Evidence-based Medicine in 2013
Ethics and Legislation Forum 醫療糾紛之淺談-以醫學美容行為為主
Speaker Ching-Chi Chi, MD, PhD Moderator Gwo-Shing Chen, MD, PhD
Speakers 王銘燦醫師 朱俊穎律師 李柏松律師 周彥吉醫師 姚志銘教授 許修誠醫師 Directors 姚志銘教授 許修誠醫師
Evidence-based medicine (EBM) has become an essential part of clinical practice, research, and medical education. The ‘pull’ of doctors’ desire for confidence in decision-making as well as the ‘push’ of patients’ request for high-quality healthcare and the accessibility of the Internet have made us in high demand for the best evidence. This talk will address how to tell between good (less biased) and bad (highly biased) evidence, review the best evidence on a number of important issues in dermatology, and address the future perspectives of evidence-based dermatology in Taiwan.
本單元除討論醫療行為之法律責任外, 亦側重於 美容行為之獨特性, 討論的主軸包括有: 一、醫療糾紛及醫療行為之定義 - 兼論醫學美容行為 二、醫療行為可能構成之民、刑事責任 (一)民事責任 1. 債務不履行與損害賠償 ˙民法第227-1條。 ˙非治療性醫學美容契約的特性，有別於一般 之醫 療行為。 2. 侵權行為損害賠償 ˙一般原則 : 民法第192 至 195條 ˙醫院與醫師之內部關係與民法188條 (二)刑事責任 業務過失致輕傷、致重傷、致死 三、實務案例之探討 四、醫學美容行為就消保法、個資法之適用探討 (及最新修正立案之醫療法82之評析) 五、結語 期望能以互動的方式, 激盪出火花, 以為醫界夥 伴行醫參考之用.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Advanced Injection Workshop Sun. May 5, 9:00~16:30
11:45 Cannula vs Needle /Hema Sundaram, MD 11:55 Q&A
Greg Goodman, MBBS, Dalvi Humzah, MBBS Greg Goodman, MBBS, Peter Huang, MD, Po-Han Huang, MD, Dalvi Humzah, MBBS, Nark-Kyoung Rho, MD, Hema Sundaram, MD Moderators Yates Yen-Yu Chao, MD, Tsen-Fang Tsai, MD , Chung-Ren Tseng, MD Directors Speakers
WS6 Live Demo 13:30-15:00 Greg Goodman, MBBS WS7 15:00-16:30
Nark-Kyoung Rho, MD Hema Sundaram, MD
Cadaver Live Broadcasting, Sponsored by Galderma Dalvi Humzah, MBB Peter Huang, MD
WS1 Introduction and Filler Issues 9:00 Introduction / Greg Goodman, MBBS 9:05 Physical Properties, Different Filler Types and New Horizons / Hema Sundaram, MD WS2 Structural Filler Issues 9:20 Using Fillers to Structurally Modify the Younger Patient / Nark-Kyoung Rho, MD, 9:35 The Part We Don't See: Looking at the Facial Profile / Hema Sundaram, MD 9:50 Scar Treatment / Greg Goodman, MBBSS 10:00 Q&A WS3 Gender Filler Issues 10:10 Sexual Dimorphism and General Concepts of Attractiveness / Greg Goodman, MBBS 10:30 Break WS4 Gender Filler Issues with Emphasis on Ethnicity 10:40 Caucasian Female Attractiveness and How to Approach It / Greg Goodman, MBBS 10:50 East Asian Female Attractiveness and How to Approach It / Nark-Kyoung Rho, MD 11:00 Caucasian Male Attractiveness and How to Approach It / Greg Goodman, MBBS 11:10 East Asian Male Attractiveness and How to Approach It / Po-Han Huang, MD 11:20 Q&A WS5 Filler Technique Issues 11:25 Product Preference / Hema Sundaram, MD 11:35 Filler complications / Nark-Kyoung Rho, MD
WS1 Physical Properties, Different Filler Types and New Horizons
categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid. Dermatol Surg. (2010).
Speaker Hema Sundaram, MD
Kablik J, Monheit GD et al. Comparative physical properties of hyaluronic acid dermal fillers. Dermatol Surg. (2009).
The primary soft tissue filler products that are currently available for aesthetic use are crosslinked hyaluronic acid (HA) including Esthélis (Belotero), Juvéderm and Restylane, calcium hydroxylapatite (CaHA) which is known as Radiesse. All are safe, efficacious and predictable. In recent years, interest has focused on the rheology (flow-related properties) of these products and how they are relevant to clinical behavior. The primary rheologic parameters that have been investigated are elastic modulus (G prime) and viscosity. Rheologic studies of HA and CaHA fillers reveal that they can be broadly divided into three groups based on their G prime and viscosity and their resultant physical properties. Group 1 fillers have high elasticity and high viscosity and therefore are firm and non-spreading. Group 2 fillers have medium to high elasticity and viscosity and are intermediate in firmness and tendency to spread. Group 3 fillers are soft, spreading fillers. This lecture provides an overview of the physical properties of CaHA and HA fillers, some key rheologic studies including important methodological considerations, and a discussion of how the results can guide the use of different filler products. Filler rheology is an exciting and rapidly advancing field. The lecture concludes with a look into the future – at new rheologic investigations of cohesivity and plasticity and how they will shape our future use of soft tissue fillers.
PHOTOGRAPHER 王大衛 David Wang is devoted to the integration of photography with different aspects of life and the promotion of esthetic sensibilities among the general public. He established Camera Coffee in 2006,which is the first theme coffee shop that focuses on photographic imaging. He is currently a commercial project photographer. 致力於影像生活化並積極推廣市民美學的提升， 2006年創辦高雄第一間以生活攝影為主題的影像 咖啡館CAMERA COFFEE，並擔任CAMERA COFFEE 商業企劃攝影師。
REFS Sundaram H, Cassuto D. Biophysical characteristics of hyaluronic acid soft tissue fillers and their relevance to aesthetic applications. Plast Reconstr Surg (2013) – in press.
Position / 卡麥拉攝影咖啡館商業企劃攝影師 photographer Website / http://www.wretch.cc/blog/wangdavid http://www.flickr.com/photos/cameracoffee
Ascher B, Rzany B, Sundaram H. (Chairs). “Fillers: Fr o m C h a r a c t e r i s t i c s t o R e c o m m e n d a t i o n s . ” Consensus panel discussion, IMCAS 2013 Annual Meeting, Paris, France.
WORKING EXPERIENCE / Grand Hi Lai Hotel 漢來大飯店 Kaohsiung Howard hotel 高雄福華大飯店 CHATEAU de CHINE 翰品高雄 Dream mall 夢時代購物中心 BOZEN SANITARYWARE & KITCHENWARE BOUTIQUE, Kaohsiung 柏正衛廚
Stocks D, Sundaram H, et al. Rheological evaluation of the physical properties of hyaluronic acid dermal fillers. J Drugs Dermatol. (2011). Sundaram H, Voigts B et al. Comparison of the rheological properties of viscosity and elasticity in two 45
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Advanced Injection Workshop Sun. May 5, 9:00~16:30
WS2 Using Fillers to Structurally Modify the Younger Patient
WS2 The Part We Don't See: Looking at the Facial Profile
The use of injectable agents, specifically injectable fillers botulinum toxin type A, has risen dramatically over recent years, due to the increased demand for minimally invasive techniques and now they represent the most commonly performed cosmetic procedures in many countries. In the treatment of the aging face, these agents, when used individually or in combination, can effectively decrease rhytids and restore lost volume. The result is a fuller, smoother, more youthful appearance. Many scientific articles and guidelines have been published regarding the use of injectables in the improvement of the aging face. However, there have been no such scientific works on the improvement of relatively “younger” patients, aging from late 20’s to mid-30’s. Since they have relatively good skin quality, muscle strength balance, and soft tissue volume, traditional concept of injectable fillers or botulinum toxin does not fit in this category of people. This article provides a current Korean trend of aesthetic filler injection for younger female patients with emphasis on the nose bridge augmentation, nose tip projection, forehead contouring, chin augmentation, and infraorbital volume restoration. Also, a couple of “East Asia-specific” procedures such as “infratarsal” augmentation which is rarely done in the Western countries will be discussed.
The rationale for prioritizing volume replacement when rejuvenating the face is that volume loss is a cardinal feature of the aging process. This lecture summarizes some recent seminal research into agerelated changes in facial anatomy that has provided an impetus toward analyzing the aging face in three dimensions, understanding the appearance it adopts, and restoring volume accordingly. We now appreciate that the aging face deflates rather than drops, and that facial subcutaneous fat is partitioned into discrete compartments, within which age-related volume loss and volume shifting occur. Age-related volume loss is a multi-level process, extending from the bone through the subcutis and dermis to the epidermis. This provides the rationale for multi-level volume restoration with fillers. Three dimensional analysis of the face and the availability of more versatile filler products has catalyzed a dramatic shift from filling wrinkles to volumizing facial zones, and the development of strategies to directly address the etiology of facial aging.
Speaker Nark-Kyoung Rho, MD
Speaker Hema Sundaram, MD
REFS Rohrich R, Pessa J. The fat compartments of the face: Anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg (2007). Lambros V. Models of facial aging and implications for treatment. Clin Plast Surg. (2008). Rohrich RJ, Pessa JE et al. The youthful cheek and the deep medial fat compartment. Plast Reconstr Surg (2008). Rohrich RJ, Arbique GM et al. The anatomy of subocularis fat: Implications for periorbital rejuvenation. Plast Reconstr Surg (2009). Rohrich RJ, Pessa JE. The anatomy and clinical implications of perioral submuscular fat. Plast Reconstr Surg (2009).
WS2 Scar Treatment
WS3 Sexual Dimorphism and General Concepts of Attractiveness
Speaker Greg Goodman, MBBS
Speaker Greg Goodman, MBBS Volumetric filling of post-acne scarring There are 3 basic methods for filling of atrophic scarring. These are: 1) Bulk filling for grossly atrophic scarred areas 2) Regional filling 3) Stalagmite filling
Sexual dimorphism is our sexual preference in a mate. It is rather hardwired and is about recognizing in a potential mate the feminine or masculine characteristics that we respond to. Male attractiveness to a female is apparently not related to strong masculine traits. The more masculine of facial features (such as increased facial width) the less trustworthy the male is regarded. Direct gaze is equated with social interest. Studying direct gaze, one group has shown that an un-partnered females have a preference for direct gaze from feminine faced males for long-term relationships but no preference the short term relationships whereas partnered women showed no difference. Males with more feminine faces were judged to be good husband material, great with children, capable of hard work and emotionally supportive by heterosexual women. More masculine appearing faces were thought to be more able to cheat on wives, and get into fights and not be good as potential sons-in-law. However, in a female attractiveness has been associated with childlike features including an even complexion, a small heartshaped face and averageness. Homosexual men have a stronger preference for a masculine face than any group, more than heterosexual females. Homosexual women showed a stronger preference than heterosexual women for masculinity in female faces. There also appears to be two sides of beauty with a sexual and nonsexual judgement of attractiveness possible. These are identified in different parts of the brain with sexual attractiveness part of the less visual field and non-sexual attractiveness part of the right visual field. Beauty has been studied by MRI and elicited neural activity in a widely distributed network involving specific parts of the brain and the degree of activity correlated with the degree of facial attractiveness. There are non-facial clues to attractiveness. Vocal attractiveness has a tangible impact on mating, job applications and electability. Averaging voices increases are attractiveness irrespective of the speakers or listeners gender and smooth voiced texture and greater similarity in pitch and timbre with the average of all
1) Case studies will demonstrate the usage of both hyaluronic acid and fat to restore and augment volume in areas of gross atrophy induced by post-acne scarring. Sometimes acne, especially cystic acne, will produce areas of destruction due to the inflammation of the acne and subsequent atrophy of tissues due to the cyst resolution. The resultant areas require bulk augmentation as surface treatments alone will do little to improve the outcome for the patient. Fat is natural, usually abundant, usually long-lasting and repeatable. However, it suffers from requiring a number of treatments and requires procedures both to harvest and implant the product. On the other hand hyaluronic acid and other offthe-shelf materials are becoming very useful for augmentation for volume loss. It is possible to use both autologous fat and hyaluronic acid in the same patient. Fat is at its best laterally and superiorly, whilst I find it difficult to achieve adequate results in the lower face and in the perioral area. 2) I find regional filling to be particularly useful in the lower half of the face and the perioral area and often in conjunction with botulinum toxin. Often an area will suffer from recurrent movement, which may wreak havoc on skin that has lost structure. An illustrative example will show the effects of botulinum toxin used to the orbicularis oris, depressor anguli oris and mentalis muscles combined with the use of hyaluronic acid to this region. 3) A new technique will be illustrated which is similar to the tower technique but just slightly different. Essentially a pillar of product is implanted deeply and perpendicularly into the scar and raised with retrograde flow towards the surface. It is important at the surface to just linger a little to allow the scar to fill maximally.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Advanced Injection Workshop Sun. May 5, 9:00~16:30
WS4 Caucasian Female Attractiveness and How to Approach It
voices is more attractive to the listener. There are many attempts to define the ideal proportions of facial structures that make males or females potentially attractive. For example there are many aspects of female appearance that conform to what is called the Golden ratio or Phi (1:1.6). This amazing ratio taht has been known at least since the time of Leonardo da Vinci defines the perfect balance between upper and lower lips, the width of the nose versus the width of the eye and is cross-cultural and even crosses species in our understanding of beautiful features and proportions. It has been suggested that the reason that some people age so well and looks so good is that they maintain these ratios throughout their lives despite the fact that individual feature may be ageing significantly. Symmetry is one of the more interesting things we look for and find attractive about others. Although asymmetry can be attractive it is more often not and asymmetry closer to the midline of the face is considered to be particularly unattractive. Very interestingly, one will adapt within five minutes or so when meeting a person with asymmetrical features and they will look better than what they did on first appearance. Apparently asymmetry is also not noted if you've had too much alcohol to drink maybe explaining a singular lack of judgement made by many in this state. Averageness is a strange concept in our understanding of beauty. It basically says that we find faces close as to what we are to be the most attractive. This may explain the phenomenon of choosing a mate of relatively similar attractiveness to ourselves.
Speaker Greg Goodman, MBBS
In Ccasian female attractiveness, one looks for no real sharpness to the face at all, a gentle unbroken curve, a small well proportioned face with a wider upper half and a narrower lower half. Caucasian females often have good eye and periorbital structures, good anterior mid-face projection, a good nose and good chin volume and structure. Caucasian females generally lack mid face width, structural support for ageing, good lip structure and skin quality. I have recently developed an algorithm based on the intercanthal distance that allows one to draw an oval outlining the face of a female. This oval shape is close to the ideal facial shape of any female (of any ethnicity) and should be an unbroken outline with the forehead merging into the temples, into the lateral cheeks, the pre-auricular region, the angle of the jaw, the jawline, the pre-jowl sulcus region and the chin without interruption. The Oval should not really change with age, in that the balance should remain the same with none of the individual features making up the Oval outline being better or worse than the others in order to maintain this balance. We can implant this oval onto all sorts of faces of attractive females and less attractive females to assess which areas may need treatment. Examples will be shown to illustrate this understanding and how it relates to relevant treatment.
WS4 East Asian attractiveness and how to approach it
mandible-chin in frontal view. The statistical evidence from many Korean studies suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face. According to the study done by Dr. Rhee in 2010, beautification of individual aesthetic subunits can predict the overall facial attractiveness up to 42.1% in frontal face and 22.7% in lateral face and aesthetic appearance of (1) eyes, (2) upper face in frontal face and (3) midface in lateral face are three statistically important factors in the cognition of facial attractiveness in Koreans. Unfortunately, fewer studies have considered the significant difference of beauty concept among the East Asian countries. In this lecture, the brief comparison of trendy concept of attractiveness/beauty among Korea, Taiwan/China, and Japan will be presented. Also, specific ways of filler injection preference according to the desired facial shape will also be discussed.
Speaker Nark-Kyoung Rho, MD
The unique aspects of East Asian beauty concept and the nuances of treating their skin require products, procedures and protocols tailored specifically to the patient. Besides, the understanding of the East Asian patientâ€™s attitude, temper, and their culture is very helpful when giving them any types of aesthetic medicine services. Of course, cultural considerations for the aging Asian patient should not be deemed monolithic in nature. This is especially true considering that even in East Asia each country, for example, Korea, Japan, Taiwan, Hong Kong, and China, has a different standard of beauty. All people have preferences on their own concept of beauty. But media is also influencing the way people define what is beautiful. The cosmetics industry is a flourishing one and still growing specially. The power of media and the arts in influencing the concept of beauty is beyond question. The movie and TV drama industry perpetuates the trendy, specific type /kind of beauties in each country. There is a concept in cultural studies about cultural relativism (different cultural groups think, feel, and act differently) and ethnocentrism (one's own culture is superior to that of other cultures). But there is no scientific standard for considering one group as intrinsically superior or inferior to another. Beauty really is in the eye of the beholder. Few studies have focused on the concept of beauty or attractiveness outside United States or Europe. However, in scientific articles written in Korean language, there are some important studies regarding the concept of beautiful or attractive face in Korea. Recent study results show that according to the general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger Koreans prefer the lozenge and inverted triangle shape contour whereas the Koreans over 40 of age prefer the egg shape contour. In chin and zygoma contour, Koreans at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the Koreans over 40 of age preferred the distinct zygoma. However, the preferred proportion of upper, middle, lower face was 1:1:1 in general. Koreans now prefer protruding forehead and small (not distinct) and V-shaped 49
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Advanced Injection Workshop Sun. May 5, 9:00~16:30
WS4 Caucasian Male Attractiveness and How to Approach It
WS4 East Asian Male Attractiveness and How to Approach It
In general male facial attractiveness is categorised by a squareness of the face, with sharp angles and in particular heavy brooding brows, a large nose, a heavy jaw angle, strong square chin with or without full lips. A study was performed by me on 13 attractive male Caucasian celebrities - namely Tom Cruise, David Beckham, Stephen Amell, Richard Gere, George Clooney, Hugh Jackman, Daniel Day Lewis, Matt Damon, Zac Efron, Pierce Brosnan, Leonardo DiCaprio, Ryan Gosling, Robert Redford, Paul Newman and Chris Hemsworth. A measurement of their intercanthal distance was made and multiples of this distance examined across the upper cheeks across the jaw lines and across the chin and the distances between these particular plotted lines. An average was established for each of these measurements and this was found to be a reliable multiple of the inter-canthal distance. The male who most closely represented the average was Chris Hemsworth but except for Ryan Gosling most were very similar to each other in these ratios. Interestingly when these ratios were used in a famous Korean celebrity OK Taecyon, very similar findings were established. From this data, treatment can be planned to improve the attractiveness of males in general and this will be illustrated
Although male attractiveness in East Asia is similar to that in Caucasian male, the perceptions of male beauty may not only be based solely on objective physical characteristics but also on culture. Interestingly, there's a feminization trend in pockets of Asia for men.
Speaker Greg Goodman, MBBS
Speaker Po-Han Huang, MD
The traditional male attractiveness in Asia under universal beauty standards are a big square jaw, which is common in northeastern Asians, a protruding browline, a straight nose, high cheekbones, and fuller lips. With the increasingly tolerant attitude toward freedom of sexual orientation, the number of men seeking to modify their faces into an elliptical shape is increasing. Therefore, there seems to have two standards of male attractiveness: younger looking and mature looking. The younger faces are narrow and a little bit feminine especially in movie stars and pop singers though some of them are still quite masculine. On the contrary, the mature stars / faces are wider and usually more masculine. In frontal view, eyes are the most important features. The masculine nose is preferred and is also the second most important male feature. In lateral view, the nose is the most important feature, with lips and chin as the second characteristic. Although narrower face is favored based on golden facial mask proposed by Marquardt, too narrow face (1:1.7) seems unattractive. Both protrusive mandible and bimaxillary protrusion are considered to be the least attractive in Taiwan possibly due to cultural and ethnic factors that are influencing perceptions (Chen YJ 2007). Men requesting alteration of a masculine face are seeking a more feminine appearance and sometimes have higher expectations than women. When we improve the attractiveness of males, balance between feminine and masculine at different age groups is very important. In this lecture, individualized treatment plans, including toxins and fillers, to meet the demands at different age groups will be discussed.
WS5 Product Preference
WS5 Filler complications
Speaker Hema Sundaram, MD
Speaker Nark-Kyoung Rho, MD
Our growing understanding of the science of fillers and the anatomical and functional changes that occur with facial aging can be integrated to provide a scientific rationale for the selection of specific filler products. Rheologic tailoring is the the strategy whereby filler products can be selected based on their elasticity (G prime), viscosity and other properties such as cohesivity and plasticity to optimize clinical results. The rheologic profile of a filler predicts how it will behave during and after implantation. It is of value in refining our use of current products, shortening the learning curve for new products, and minimizing the risk of complications. This lecture with video demonstrations discusses preferred regional injection techniques for CaHA and HA fillers based on rheologic tailoring in combination with systematic pre-treatment analysis of the facial tissues. For example, sculpting of the nose, cheeks or chin can be well-performed with a firm, non spreading product such as CaHA that provides maximal tissue support and contour stability. In contrast, a softer, more spreading HA product may be preferred for augmentation of the lips. Evidence-based selection of injection techniques such as anterograde versus retrograde flow, and serial puncture versus threading is also based on the principles of rheologic tailoring in combination with pre-treatment evaluation.
Dermal fillers are increasingly being used for facial soft tissue augmentation. Like every medical and surgical procedures, injectable fillers are not free from various types of complications. Erythema, edema, bruising is not regarded as filler-related complications in general. Acute hypersensitivity reaction can occur as early adverse events, but this occurs only rarely and well treated by medical treatment in general. Among the early complications, injection necrosis is a rare but most important accident that is caused by interruption of the vascular supply to the area by compression, injury and/or obstruction of the vessel. Injection necrosis can appear to be pyoderma or a local wound infection (e.g., herpes viral infection, impetigo, folliculitis), and so physicians should pay attention to make an accurate diagnosis. Basic knowledge of its prevention, early detection, and proper management is crucial to any injectors. To get such knowledge, the injector should be familiar with arterial anatomy of the face and its variations. Understanding of the filler injection rheology and the physiochemical nature of the filler product is also important. Nodules, granuloma, migration, cold abscess are classified as late complications and usually related with the nature of the filler product. For late complications, the most important step is to identify the exact nature of the lesion because treatment modalities will vary according to the complication type. In this lecture, various clinical presentations of injectable filler complications will be provided and the authorâ€™s guideline for treatment will be presented.
REFS Sundaram H, Carruthers J. Volumetric Approach to the Midface. (2013) Clin Plast Surg (in press) Sundaram H, Carruthers J. The Glabella and Central Brow. In: Carruthers J, Carruthers A eds. Proc Cosmetic Dermatol: Soft Tissue Augmentation. UK: Elsevier. (2013). Sundaram H, Kiripolsky M. Nonsurgical rejuvenation of the upper eyelid and brow. Clin Plast Surg (2013). Sundaram H, Flynn T et al. New and Emerging concepts in soft tissue fillers. J Drugs Dermatol (2012).
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Advanced Injection Workshop Sun. May 5, 9:00~16:30
WS5 Cannula vs Needle
WS6 Live Demo
Speaker Hema Sundaram, MD
Director Greg Goodman, MBBS Speaker Greg Goodman, MBBS Nark-Kyoung Rho, MD Hema Sundaram, MD
Todayâ€™s clinician has a variety of tools from which to select for the injection of soft tissue fillers including blunt microcannulas and sharp needles of various gauges and lengths, and assisted injection devices. This lecture with video demonstrations provides strategies for selecting the best tools for soft tissue augmentation, based on anatomic and safety considerations, analysis of volumetric needs, the product(s) selected for use, and treatment objectives. A brief review of pertinent literature is provided, including summary of a recent consensus document that provides strategies for selecting the appropriate cannulas for different facial regions and filler products and techniques for using them alone or in combination with sharp needles. It is recommended that clinicians strive to master both blunt cannula and sharp needle techniques, in order to provide the safest and most efficacious results for their patients. Assisted injection devices are also a strong consideration since they have been shown in studies to significantly decrease patient discomfort and postinjection recovery time. REFS Cassuto D, Sundaram H. Diagnosis and management of nodules from the aesthetic use of hyaluronic acid and calcium hydroxylapatite fillers: an algorithmic approach. Plast Reconstr Surg (2013 â€“ in press). Sundaram H, Weinkle S et al. Blunt-tipped microcannulas for the injection of soft tissue fillers: A consensus panel assessment and recommendations. J Drugs Dermatol (2012). Sundaram H. Deep lifting volumetry with calcium hydroxylapatite and hyaluronic acid fillers. J Drugs Dermatol. (2012). Zeichner J, Cohen JL. Use of blunt-tipped cannulas for soft tissue fillers. J Drugs Dermatol (2012).
Cadaver Live Broadcasting, Sponsored by Galderma
Greg Goodman, MBBS Greg Goodman, MBBS Peter Huang, MD Moderator Yates Yen-Yu Chao, MD Director Speaker
To educate and excite visitors anatomies of full face and demonstrate filler injection techniques during an educational symposium. This lecture on face volume aims to: UK site- Led by Dr. Dalvi Humzah •Show the structure and layer of full face and highlight dangerous zone when conduct filler injection •Show the injection sites on upper, mid and lower face and the microcannula path under the skin and the anatomical plan •Show the injection sites and use colored gel to identify where the HA goes and how it stays in tissue TW site- Led by Dr. Peter Huang •Compare with anatomy of full face and show live HA injections with full face assessment on a patient
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! s t n e v E l a i c Spe Pre-conference: BotulinumtoxinA Workshop Sponsored by IPSEN 10:00~17:40@Chateau de Chine, Kaohsiung
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Hair Symposium
Sun. May 5, 9:00~11:50 HS1 Current Situation of Hair Trans/ plantation in Mainland China
Speakers Wen-Yu Wu, MD, PhD Chien-Hsun Chen, MD John P. Cole, MD Jerry Shapiro, MD Directors Jerry Shapiro, MD, Ren-Yeu Tsai, MD
Speaker Wen-Yu Wu, MD, PhD
Current Situation of Hair Transplantation in Mainland China / Wen-Yu Wu, MD, PhD
本次演讲介绍了目前中国大陆植发市场分析（20062011年市场规模、产值的分析）、植发机构介绍 （2006-2011年机构数量的增长、公立植发机构和民 营植发机构介绍）、植发技术介绍（FUT、FUE、 SHT、BHT等），中国人植发特点（毛发特征、供 区、受区特点）、植发技术的展望（机器人植发、 毛囊细胞再生技术）。
HS2 ARTAS Robotic Hair Restoration 9:30 / Chien-Hsun Chen, MD HS3 The Advantages of FUE Megasessions 10:00 for hair Restoration Surgery / John P. Cole, MD
This lecture describes current market analysis on Chinese hair transplantation (analysis of market scale and output during 2006-2011), brief introduction of hair transplantation clinics ( the change of hair transplantation clinic’s number during 2006-2011, and introduction of both public and private hair transplantation clinics), the technology of hair transplantation (FUT, FUE, SHT, and BHT etc), the characteristics of hair transplantation in Chinese (including hair features, donor area, and recipient area features), and the prospect of hair transplantation development (restoration robotics and hair follicles regeneration technology).
HS4 Latest Updates of Finasteride for 11:00 Male Pattern Hair loss / Jerry Shapiro, MD
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Hair Symposium
Sun. May 5, 9:00~11:50 HS2 ARTAS Robotic Hair Restoration
HS3 The Advantages of FUE Megasessions for Hair Restoration Surgery
Speaker Chien-Hsun Chen, MD
Speaker John P. Cole, MD FUE ( follicular unit extraction ) has been existing in the field of hair restoration surgery for long term . However, using FUE technique to obtain hair follicles , physicians have to do hundreds to thousands of punches precisely over the scalp one by one. Hence , getting familiar with this skill would be a steep curve and very fatiguing. Even though FUE can reduces the possibility of visible scars and postoperative patientsâ€™ discomfort , FUE is still not a major surgery in the hands of many experienced hair transplant doctors
The Advantages of FUE Megasessions for Hair Restoration Surgery and Strategies to Provide Them Background: Hair restoration surgery evolved from 4 mm plugs to follicular units over a span of 30 years. It then took another 10 years for the advantages of follicular unit transplantation with strip harvesting (FUT) to become commonplace. Follicular unit extraction (FUE) formally began in 2002 and took 10 years to exceed 30% of all hair restoration surgery procedures. There are a number of reasons why procedures take a full decade to become commonplace when they clearly offer many advantages over their predecessors. Physicians are comfortable with their existing procedures so they are reluctant to change. Physicians wait to see that new procedures offer results consistent to or better than results from existing procedures. Newer procedures that require greater skill, time, and energy are never easily accepted. A surgery team must be trained to manage a new procedure.
Utilizing the repeatability and precision of robotic techniques up to date, the robotic FUE harvesting of hair follicles has been conducted into the hair surgery since 2011. This system named as ARTAS works by first taking the precise 3D images of the scalp and then measuring the angle and direction of each hair follicle . Next, the computer will guide the needle to go in and punches individual hair follicles out of dense areas. Not only can the robot make hundreds of grafts in short time but also consistently produce quality grafts which increase survival rates.
As the advantages of newer procedures become clearer to the patient population, patients begin to express a preference or an interest in these newer procedures. Eventually, the demand for newer technology reaches critical mass. Physicians can no longer sit in their comfort zone with their old procedures. They are forced to learn new technologies and procedures. Meanwhile, as the new procedure develops over a span of 10 years, the technology advances as does the size of the case. Fore example 1000 graft strip surgery follicular unit cases in 1992 were replaced by 3000 to 5000 graft cases by 1998. Graft production with a simple magni-focuser or the naked eye was replaced by microscopes. With FUE, the size of cases expanded from 500 grafts per day to over 4000 grafts per day by 2012. Technology advanced from manual extraction to mechanical extraction. Technology always advances with a goal to provide the optimal patient outcome. Unfortunately, as technology advances, the demands on a physician new to the procedure faces greater 58
HS4 Latest Updates of Finasteride for Male Pattern Hair loss
obstacles based on the number of grafts and advanced technology. Hair transplant megasessions transfer several thousand grafts in a single sitting. The size of a megasession is typically larger with Caucasian patients than it is with eastern Asian patients because follicular unit density is greater with Caucasian patients. The follicular density of the western Asian population (i.e. India) is more resembles that of the Caucasian population. Still megasessions in eastern Asia generally exceed 2000 grafts. Megasessions of FUE and FUT offer similar advantages to patients. These include a faster result and fewer surgical interventions. Unlike FUE, multiple FUT procedures are prone to produce a wider scar, however.
Speaker Jerry Shapiro, MD
Finasteride is a potent and highly selective inhibitor of 5 alpha reductase type 2. Taken orally it reduces DHT levels in serum and in scalp by up to 70%. Two types of 5 alpha reductase inhibitors exist in humans. Type 1 predominates in liver, skin and scalp and Type II in prostrate and genitourinary tract and also in hair follicles. Finasteride is a type II, 5 alpha reductase inhibitor. Finasteride was developed for treatment of benign prostrate hyperplasia and in 1993 was registered in US for treatment of mild to moderate MPHL. Finasteride is quickly absorbed after oral intake with peak plasma level occurring 1-2 hours after drug intake. The serum half- life is about 6 hours, the biological effect persists much longer. Recommended dosage is 1 mg once daily taken with or without food. If a patient forgets a pill, taking the double dosage the next day is not recommended. Finasteride is metabolised in liver through oxidative pathway (cytochrome P4503A4) although no drug interactions have been noted with drugs metabolised by a similar pathway. Dosage need not be adjusted in case of renal insufficiency. Finasteride has been shown to increase both total and anagen hair counts. Finasteride prevents or slows the progression of MPHL and about two-third experience some improvement..The improvement peaks at around 12 months. Finasteride has been shown to produce significant and durable increase in hair growth in men with pattern hair loss. The previously miniaturized hair become longer and thicker. Finasteride is more effective over vertex and superior-frontal region of the scalp, compared with minimal response over the temporal and anterior hairline region. Treatment should be continued because the benefits will not be maintained after ceasing therapy. Baseline photographs of vertex and frontal hair line are helpful and repeated at 6 monthly to yearly interval to monitor treatment response. Patients are able to observe their regrowth which serves as a motivating factor improving long term compliance to medical treatment. Patient should be made aware of the pros and cons and participate actively in decision making. Finasteride
Methods: This presentation will trace the history of FUE from itâ€™s infancy to itâ€™s present state. Results: FUE has advanced from a small procedure to a very large procedure. One of the presumed disadvantages of FUE was that it required several days to perform a procedure as large as a single strip procedure. Coordinating the surgical team and improvements in instrumentation allow FUE to be performed as rapidly as a strip procedure of the same size often times with less staff. Advancements in mechanical extractors allow the surgeon to rapidly extract grafts. Proper coordination of the surgical team allows rapid insertion of the grafts. Surgical outcomes from FUE are equal to and often superior to FUT. Discussion: FUE has evolved into a procedure capable of producing optimal results for patients over a span of time. Follicle transection rates are often lower than from strip harvesting. Yields are equivalent to strip harvesting. FUE procedures may be performed as fast as strip harvesting with fewer staff members. The potential for donor area scarring is less following maximal harvesting of the donor area. This allows patients better options regarding their hair styles following FUE.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Hair Symposium
Sun. May 5, 9:00~11:50
Meet and Dine with Experts
can cause loss of libido, ejaculatory dysfunction, gynecomastia and potential depression in a very small number of individuals. In a small number of patients, sexual adverse effects can be persistent. Finasteride reduces PSA level. If treatment is started after age 45, monitoring of PSA level should be considered. The PSA level should be doubled to compensate the reduction due to finasteride , resulting in an interpretation of the test remaining accurate. The level of finasteride in the semen of treated men is very low even with regular intake of finasteride 5 mg/ day,and there is no risk in case of sexual relation with pregnant women. Use of condom is not necessary for this reason. Women who are or potentially may be pregnant should not handle crushed or broken tablets. Finasteride tablets are coated to prevent contact with the active ingredients during manipulation.
SUNDAY, MAY 5
本次大會創舉! 與大師共進晚餐的難得經驗! 若您尚未登記與大師見面的機會， 請速洽大會秘書處預約繳費(1000/人)
Steven Feldman, MD, PhD Chee-Leok Goh, MD, MBBS Greg Goodman, MBBS Adelaide Hebert, MD Ronald Moy, MD Hema Sundaram, MD WenChieh Chen, M.D., Ph.D.
GOLF SATURDAY, MAY 4 am10:00~pm15:00
地點：高雄高爾夫球場(高雄市鳥松區大華里球場路270號 ) 聯絡人：何宜承醫師 firstname.lastname@example.org
SCIENTIFIC SESSIONS SUNDAY, MAY 5 KAO Eczema Symposium Sun, May 5, 9:00~11:50
ES1 Updates of Genetic Abnormalities in Atopic Dermatitis: From SNP to GWAS
Speakers Chih-Hung Lee, MD, Ph D Li-Fang Wang, MD, PhD Chih-Hung Lee, MD, PhD Mao-Qiang Man, MD Tzu-Kai Lin, MD Chia-Yu Chu, MD, PhD Jiu-Yao Wang, MD, DPhil (Oxon) Genji Imokawa, PhD Directors
Speaker Chih-Hung Lee, MD, PhD Atopic dermatitis (AD) is an important allergic disease that usually heralds allergic rhinitis and asthma. The pathogenesis of AD is complex and involves the interactions of intrinsic genetic abnormalities and extrinsic environmental inputs. The genetic background of AD is evidenced by trend of the family aggregation studies and genetic clustering analysis. The genetic abnormalities in AD could be classified into regulatory genes for barrier function and immune responses. Initially, association studies with single nucleotide analysis has contributed to the understanding of disease association factors. Next, genome-wide association studies (GWAS) have further advance our understanding of the genetic regulatory network in AD. In this post-genomic era with several high-throughput functional genomic analysis, coupled with the integration of finely-defined phenotypes of AD and availability of large human database, the advance of AD genetic analysis has been making a great stride recently. Combined with the epigenetic analysis, those studies help establish the base to carry out the functional and mechanistic studies in AD. We presented out recent findings about the genetic analysis ORAI1, a calcium channel important in T cell activation, as well as IL-31, a pruritic cytokine, in AD based on hospital-based case control design. This talk also updates the genetic abnormalities focusing on the functional outcomes in AD and makes the perspective in the future trend of genetic analysis in AD.
Mao-Qiang Man, MD, Hamm-Ming Sheu, MD, MSc
ES1 Updates of Genetic Abnormalities in 9:00 Atopic Dermatitis: From SNP to GWAS / Chih-Hung Lee, MD, PhD ES2 The Immunopathogenesis of Atopic 9:10 Dermatitis / Li-Fang Wang, MD, PhD ES3 Pathophysiology and 9:30 Immunopathology of Itch: From Skin to Brain / Chih-Hung Lee, MD, PhD ES4 Regulatory Role of Epidermal 9:40 Permeability Barrier Function in Cutaneous Inflammation: Implication in Preventing and Rreating Cutaneous Inflammation / Mao-Qiang Man, MD ES5 Skin Barrier Defects in Atopic and 10:10 Eczematous Disorders and Barrier Therapy / Tzu-Kai Lin, MD ES6 New Trends in Atopic Dermatitis 10:20 Management / Chia-Yu Chu, MD, PhD ES7 The Effects of Probiotics on the 10:35 Improvement of Atopic Dermatitis / Jiu-Yao Wang, MD, DPhil (Oxon) ES8 Role of Stratum Corneum Ceramide 11:00 in Cutaneous Permeability Barrier Function: Implication to the Pathogenesis of Atopic Dermatitis / Genji Imokawa, PhD
SCIENTIFIC SESSIONS SUNDAY, MAY 5 KAO Eczema Symposium Sun, May 5, 9:00~11:50
ES3 Pathophysiology and Immunopathology of Itch: From Skin to Brain
ES2 The Immunopathogenesis of Atopic Dermatitis Speaker Li-Fang Wang, MD, PhD
Speaker Chih-Hung Lee, M.D., Ph.D. 異位性皮膚炎是環境中的過敏原，進入人體，在異 位性體質者引發免疫反應，至皮膚導致的長期、反 覆性急慢性皮膚炎。本文將就異位性過敏原、異位 性體質、兩者交互作用引發的免疫反應、以及急慢 性皮膚炎的特性及最新了解，分別加以闡述。
Atopic dermatitis (AD) is a common allergic disease. Itch, the main symptom of AD, results from activation of cutaneous nerve endings elicited by certain mediators, including neuropeptides and cytokines. Poor barrier functions and immune abnormalities coordinately contribute to itch in AD. Transepidermal water loss (TEWL), an indicator for barrier function, is associated with itch intensity in AD. We reported that serum level of beta-endorphin, a neuropeptide, is independently associated with pruritus intensity. IL31, a Th2 cytokine, has been reported to associated with pruritus in AD. IL-31 receptors are present in epidermal keratinocytes. We found that high levels of blood beta-endorphin and IL-31 are significantly correlated in patients with AD. Both IL31R expressions and beta-endorphin were increased and colocalized in AD skin. The result showed that beta-endorphin is increased from IL-31-treated keratinocytes. Activation of IL-31 receptor resulted in calcium influx and STAT3 activation. Pretreatment with STAT3 inhibitors abolished the increase of beta-endorphin. Either replacement of extracellular calcium or treatment with 2-APB, an inhibitor for the store-operated channel, blocked STAT3 activation. We concluded that IL-31R activation in keratinocytes induced calcium influx and STAT3-dependent betaendorphin production. Targeting IL-31 and/or betaendorphin might provide a niche for treating itch in AD.
ES4 Regulatory Role of Epidermal Permeability Barrier Function in Cutaneous Inflammation: Implication in Preventing and Rreating Cutaneous Inflammation
ES5 Skin Barrier Defects in Atopic and Eczematous Disorders and Barrier Therapy Speaker Tzu-Kai Lin, MD Contact dermatitis (CD) and atopic dermatitis (AD) are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Patients with AD have increased frequency of CD. Mutations in the epidermal differentiation complex which contains the gene filaggrin, in cornification (loricrin and transglutaminase), and epidermal barrier genes (serine protease inhibitor Kazal-type 5, involucrin, keratin 16) have been identified in AD. Not only lesional skin in AD but also nonlesional skin decreases expression of many terminal differentiation proteins. Increased transepidermal water loss was also reported in both nonlesional and lesional skin in AD, suggesting a “background” of the intrinsic defective barrier. The defective barrier not only alters permeation of xenobiotics or haptens but might also prime immune responses. Keratinocytes are the principal and first cells to secrete cytokines after and epicutaneous stimulus. Sustained hapten access through a defective barrier simulates a Th1→Th2 shift in immunophenotype, which in turn further aggravates the barrier. This “outside–to-inside, back to outside” paradigm for the pathogenesis of AD provides impetus for the “barrier therapy” in treating AD and CD. These approaches could range from lipid supplement, normalizing epidermal differentiation (e.g. topical activators of peroxisomal proliferator activator or topical antihistamine), reduction in the pH of SC, or improving antimicrobial defense.
Speaker Mao-Qiang Man, MD 皮膚局部和機體系統的生物功能均可調節表皮通透 屏障功能，而表皮通透屏障功能對皮膚的功能（包 括表皮抗菌肽的表達、DNA及表皮脂的合成）也 有調節作用。皮炎是臨床最常見的皮膚病之一。 在表皮通透屏障功能降低時，皮膚細胞炎症因數 （cytokines）的釋放增多、mRNA的表達增高；表皮 CD44表達增強；表皮langerhans細胞增多，而且增 多的程度與表皮通透屏障功能降低的程度成正比； 真皮Mast Cell增多；皮膚接觸性皮炎反應的敏感性 增強；增加皮膚局部金黃色葡萄球菌(staphylococcus areaus)菌落形成。在臨床上，表皮通透屏障功能的 降低至少與某些特應性皮炎（atopic dermatitis, AD)及 銀屑病（psoriasis）的發生與發展有關。增強表皮通 透屏障功能不僅能有效地改善皮膚炎症，還能延緩 AD的復發。改善表皮通透屏障功能已成為防治某些 皮膚病（尤其伴有皮炎的皮膚病）的手段之一。
SCIENTIFIC SESSIONS SUNDAY, MAY 5 KAO Eczema Symposium Sun, May 5, 9:00~11:50
ES6 New Trends in Atopic Dermatitis Management
傳統口服抗組織胺的副作用：像嗜睡、口乾、便 秘、食慾增加、影響學習、心律不整、心悸等，有 些抗組織胺還有抗過敏、抑制白血球趨化作用等效 果。此外，局部塗抹止癢藥膏也是一種迅速止癢的 好方法，可以有效避免病患過度搔抓皮膚、防止病 灶惡化。 長期使用類固醇會有許多副作用：包括皮膚萎 縮、變薄、皮膚色素改變、長毛、出現細血絲、皮 膚感染，甚至造成許多如妊娠紋般的擴張紋，如果 吸收到人體之中，還有可能影響到荷爾蒙的分泌， 造成發育不良、感染與內分泌失調等情形。新一代 的「局部calcineurin抑制劑 (TCI) 藥膏｣ 可以直接抑 制T細胞的活化，阻止細胞激活素 (cytokines) 的釋 出，因此能有效抑制皮膚的免疫反應，又不會造成 像類固醇一樣的副作用。其中tacrolimus ointment不 論是0.1%或0.03%，對於2歲以上中度至重度異位性 皮膚炎患者都有顯著的療效，可以短期或間歇性長 期使用。Pimecrolimus 1% cream在治療3個月以上的 嬰兒、兒童與成人的輕、中度異位性皮膚炎也具 有顯著的療效，可以迅速地達到止癢、消炎的效 果；更重要的是，研究證實它還具有預防異位性皮 膚炎惡化的效果：在大規模的對照研究中，使用 pimecrolimus 1%的病患在半年後與一年後仍有高達 61%與51%的人沒有復發；相反地使用傳統治療的對 照組在半年後與一年後沒有復發的比例只有34%與 28%。因此pimecrolimus 1%也具有減少使用類固醇的 功能。 最近，歐洲的大規模研究也顯示，運用局部塗 抹tacrolimus藥膏可以長期間歇使用，連續一年的期 間中每週使用二次，可以有效控制異位性皮膚炎、 避免復發，又不會造成皮膚的副作用。 適度地減少塵螨暴露、避免吃會過敏的食物，的確 對病情有所幫助。然而過度限制飲食，反易造成營 養攝取不均衡、增加病童心理壓力、使家長精疲力 竭，反而疏忽了更重要的治療措施。在嬰兒時期， 可使用水解奶粉、少吃海鮮、少吃蛋白等飲食控制 措施，但必須注意營養攝取均衡、避免影響孩子的 情緒。塵螨暴露的控制也是非常重要的輔助措施， 但是卻不宜當作唯一的治療方法。除此之外，環境 中的過敏原還包括黴菌、貓毛、狗毛、蟑螂等等， 這些也都要注意。 對於少數極度嚴重的異位性皮膚炎患者，現 在已經有一些學者認為應該使用口服免疫抑制劑 來控制病情，成效良好且無長期使用類固醇的許
Speaker Chia-Yu Chu, MD, PhD 異位性皮膚炎 (atopic dermatitis、AD) 是一種慢 性反覆性的皮膚疾病，通常好發在嬰兒期或兒童 期，其特徵是皮膚發炎會有典型的分布位置，嬰幼 兒時期好發於臉頰與四肢伸展側；兒童期以後會逐 漸轉變至脖子、鼠蹊、手彎、手腕、腳彎等四肢彎 曲皺摺處。患者常常同時伴有血清中E型免疫球蛋 白升高、個人或家族有過敏性鼻炎、氣喘或異位性 皮膚炎等病史。 雖然異位性皮膚炎的致病機轉相當複雜，包括 基因上具有易感性（susceptibility）、過敏免疫功能 的失調、週遭環境的影響、生化代謝上的異常與皮 膚障壁功能的缺陷等等因素，多種因素共同作用的 情形下最後才導致異位性皮膚炎的發生，但是近年 來基因體醫學的發展，發現異位性皮膚炎的基因與 表皮角質分化蛋白filaggrin的基因缺陷有密切相關， 顯示異位性皮膚炎最初發病的原因並非身體免疫體 質異常，而是皮膚本身在分化上的不正常，才造成 後天的過敏體質反應。過去皮膚科研究早已發現異 位性皮膚炎病患的皮膚障壁功能有顯著的缺損，包 括經皮水分散失度 (TEWL) 明顯上升、角質層含水 量減少與皮膚天然油脂含量下降，這樣的現象即使 是在病患的正常皮膚也很顯著，因此顯然不是因為 皮膚發炎所造成。 在嬰幼兒時期，大部分的異位性皮膚炎患者還 未有過敏原的致敏化，產生濕疹的原因主要是皮膚 障壁功能不佳、導致外來刺激物引發發炎反應，所 以應盡量減少免疫抑制藥物的使用；同時在濕疹獲 得控制後，應多擦保濕劑或潤滑劑來回復障壁功 能。專門針對異位性皮膚炎使用的潤滑劑，往往可 模仿角質層的組成，提供更多具有滋潤效果的油 脂、含水劑、維生素，特別是補充含有神經醯胺的 乳液，已經被證實可以有效重建原本受損的皮脂 膜。 急性發作時期，局部塗抹類固醇藥膏仍是目前 最有效的方法。短暫使用合適的類固醇藥膏是一種 精密的技術，必須考慮到各種類固醇藥膏的強度、 基劑的特性、病患的年齡與身體各部位的皮膚厚度 等等。此外，異位性皮膚炎治療上最重要的關鍵便 是止癢，目前最主要的治療方法是口服抗組織胺， 尤其是現在新一代的口服抗組織胺比較不會有以往 64
ES7 The Effects of Probiotics on the Improvement of Atopic Dermatitis
多副作用，目前較常使用的藥物包括azathioprine 與cyclosporine。此外，光療也是值得考慮的治 療措施。目前較常使用的光源種類包括UVA-1與 narrowband UVB。 此外，針對不同國家地區的氣候與環境特性， 也應制定不同的治療準則；最近亞太地區幾個國家 的專家學者也針對東南亞與澳洲特有氣候、環境與 社會經濟因素，提出了具有地域特殊性的異位性皮 膚炎治療指引。 由於現有的治療方式仍然無法對中重度的異位 性皮膚炎提供有效且安全的控制，目前仍有許多新 的治療方式正在進行臨床試驗評估，可能的幾個新 方向包括：皮膚障壁治療 (barrier therapy)、新一代抗 金黃色葡萄球菌治療、新的免疫調節藥物與抗IgE藥 物、新一代止癢藥物、飲食與益生菌治療等等。
Speaker Jiu-Yao Wang , MD, DPhil 過敏性皮膚炎(Allergic Dermatitis)又稱為異位性 皮膚炎（Atopic Dermatitis），是過敏性疾病中影響 日常生活又難以治療的全身性疾患。根據文獻資料 指出，如嬰幼兒在一歲前罹有異位性皮膚炎，在三 歲會有過敏性氣喘及鼻炎的機率，較健康嬰幼兒發 生的比率會高出8倍至10倍。根據過去的台灣新出 生幼兒世代研究的初步結果發現，在台灣6個月大 的嬰幼罹有異位性皮膚炎過逹6.9%，而在20年前只 有1.5%，增加了近四倍多。發生異位性皮膚炎的危 險因子，除了與父母基因遺傳有關環境中潮溼的空 氣、壁癌(長黴菌)都有高度的相關，由於異位性皮 膚炎是一種嚴重型的過敏疾病，所以如何從嬰幼 兒－初生起就開始預防便成為臨床上重要的研究課 題。近年來，Kalliomaki的報告及後續的研究指出， 若母親在產前服用(Lactobacillus,GG)三個月且其新生 兒也服用益生菌一年，不只是異位性皮膚炎下降五 成，在三歲以後發生過敏性氣喘也相對的減少。 另外在實驗動物模式的研究，也發現餵食乳酸 益生菌，過敏性皮膚炎也得到改善。我們在過去的 研究中，也發現餵食L.gasseri乳酸菌的小鼠也可以改 善過敏原所誘發的氣喘發炎反應，具有抑制Th17淋 巴球的免疫調節作用。但是對於異位性皮膚炎改善 的機轉，至今仍未清楚。因此在本次研究，我們將 針對L. gasseri益生菌及其菌質萃取物來分析對小鼠 異位性過敏皮膚炎的改善效果，進一步可以了解益 生菌在宿主內的免疫調節機轉，進而從益生菌菌質 萃取物中提錬出天然有效物質，將健康食品提昇層 次，進而改善功效，增加產品在市場的利基，以提 高本國生物科技的產業競爭性。 At o p i c d e r m a t i t i s ( A D ) , a c h r o n i c r e l a p s i n g inflammatory skin disease, is highly prevalent around the world affecting approximately15%-30% of children and 2%-10% of adults. The hallmarks of atopic dermatitis are a chronic, relapsing form of skin inflammation, a disturbance of epidermal-barrier function that culminates in dry skin, and IgE-mediated sensitization to food and environmental allergens, which usually start during early infancy or childhood. AD is caused by complex factors with genetic, immunological, and environmental aspects. Since the 65
SCIENTIFIC SESSIONS SUNDAY, MAY 5 KAO Eczema Symposium Sun, May 5, 9:00~11:50
ES8 Role of Stratum Corneum Ceramide in Cutaneous Permeability Barrier Function: Implication to the Pathogenesis of Atopic Dermatitis
pathogenesis of AD remains unclear, we would like to establish an AD disease mouse model to investigate the immunopahogesnesis as well as screening potential therapeutic agents for this allergic disease. Hairless (SKH1) mice were repeatedly epicutaneous (EC) sensitized with protein allergen (OVA) or house dust mite allergens, Der p. We found the skins of EC-sensitization mice were dry and trans-epidermal water loss (TEWL) of these AD mice were higher than control mice indicated that the skin barriers were damaged by repeated EC sensitization. In histology, their skins developed lesions characterized by epidermal and dermal thickening with inflammatory cells and eosinophils infiltrations. Also, thymic stromal lymphopoietin (TSLP), a cytokine secreted from keratinocytes that triggering dendritic cell-mediated T helper (Th) inflammatory responses, is highly expressed in the epidermis and dermis region of AD skins and associated with Langerhan’s cells migration in EC-sensitization mouse. Although the levels of total IgE and Der p-specific IgE were not detectable, but increased expression of IL-17 and INF-γ cytokines were found in this “outside-in” AD mouse model, which is compatible with Th17-type dominant inflammation. In the further study, we will apply this “outside-in” mouse model of AD to investigate the preventive or therapeutic effect of probiotics in the immunoregulation or disease modification of AD.
Speaker Genji Imokawa, Ph.D.
Abnormality in Barrier Function There is a general consensus that disruption of the barrier function of the stratum corneum (SC) is an essential etiologic factor for skin inflammation in patients with atopic dermatitis (AD). Since AD could be considered a barrier disease in which antigens and irritants that have penetrated (or permeated) the skin, trigger and worsen the dermatitis, using the photoacoustic spectrometry system, we evaluated in vivo cutaneous permeability and found that dyes penetrated faster in clinically normal (atopic dry) skin of patients with AD compared with healthy subjects, indicating an impairment of the in vivo cutaneous permeability barrier function against both lipophilic and hydrophilic chemicals . Inflammatory or Post-Inflammatory Event ? To determine whether disrupted barrier function in the nonlesional skin is associated with inflammatory or post-inflammatory events, which are relevant to the severity of AD or local dry skin properties, respectively, we evaluated the barrier function and the water content of nonlesional forearm skin and compared these with the severity of AD. The transepidermal water loss (TEWL) significantly increased in proportion to the severity of AD with a markedly high correlation coefficient (r = 0.834, p< 0.0001, n = 106), indicating that the barrier disruption in the nonlesional skin is well suited to reflect the severity of AD and that the non-lesional skin had already been inflamed and has never been purely intact skin since birth . Is Barrier Abnormality Inherent or not ? It is of importance to ask whether the impairment of skin barrier function in AD is inherent or not. In this respect, a prospective study using newborns revealed that impairment of skin barrier function is not inherent with AD patients . Consistent with the non-inherent and post-inflammatory events, analysis of SC function in babies infant skin with AD where 66
barrier function which occurs in essential fatty acid deficiency mice or is elicited by surfactant or solvent treatment can be repaired by the topical application of pseudoceramides [17-19]. Th1/Th2 Balance and Ceramide In connection with Th2 dominance, we have recently highlighted the effects of Th1/Th2 cytokines on ceramide levels in the SC and have found in the modified system of human epidermal equivalents that Th2 cytokines (IL-4/IL-6) result in a marked decrease in SC ceramide levels which are accompanied by the down-regulated expression of the genes encoding serine-palmitoyl transferase-2, acid sphingomyelinase (aSMase) and beta-glucocerebrosidase (BGCase) in the epidermis . These findings suggested that the Th2 type of inflammation evoked in AD skin is an essential factor in down-regulating the levels of ceramides in the SC although the precise cellular mechanism(s) involved in cytokine-induced alteration of ceramide metabolism remains to be determined.
the non-lesional skin can be considered relatively the intact skin compared with that of adult AD revealed that while TEWL was significantly up-regulated in the AD lesional, but not non-lesional arm skin compared with healthy control (HC) skin, water content was slightly but not significantly decreased in only the lesional arm skin . In the bottom skin of infants with AD, both TEWL and water content did not differ between the AD non-lesional skin and the HC skin. Contribution of Th1/Th2 balance Since AD patients have constitutive barrier-disruption even in non-lesional skin and since they acquire Th2 dominance in relation to their high sensitivity to various allergens, we assessed the immunological responses in afferent and efferent phases of the sensitization with picryl chloride (PiCl) and house dust mite antigens (MA) through barrier-disrupted skin . We found that percutaneous sensitization by a single topical application of haptens or the AD-specific macromolecular antigen, MA, following cutaneous barrier-disruption, elicits a Th2-dominant immune response that is distinct from the response elicited by sensitization with haptens through intact skin, suggesting that the Th2 dominance in AD is greatly associated with the constitutive barrier impairment but not with the innate immunological abnormality.
Is Ceramide Deficiency Inherent or not ? Since adult AD non-lesional skin may be postinflammated skin, it remains unclear whether ceramide deficiency results from post-inflammation or from hitherto inherited ceramide synthetic abnormality. To test this question, we used babiesâ€™ infant skin with AD to compare with SC ceramide levels and BGCase activity in the both upperarm and bottom skin in parallel to the previous barrier experiments . Comparison of ceramide levels demonstrated that whereas there was no significant difference in SC ceramide and bound-ceramide levels in the bottom skin between AD and HC, SC ceramide but not bound-ceramide levels were significantly reduced in only the lesional upperarm skin of AD compared with HC. On the other hand, there was no significant difference in SC BGCase activity in the upperarm and bottom skin between AD and HC. These findings suggest that the barrier disruption due to ceramide deficiency is essentially dependent on non-inherent and post-inflammatory events in in babiesâ€™ infant skin with AD.
Role of Ceramide Previous studies have shown that the barrier disrupted dry skin of AD patients is mainly attributable to significantly decreased levels of ceramides (evaluated as Âľg ceramide/weight or protein of the SC) in the SC . Ceramide acts as a water modulator  and a permeability barrier by forming multi-layered lamellar structures with other lipids between cells in the SC layers . In adult AD, there is a ceramide deficiency even in the non-lesional SC, which is highly associated with the abnormal barrier function, predisposing inflammatory processes evoked by irritants and allergens. The ceramide deficiency in the SC of the AD skin has been substantiated in many additional reports [9-14]. The significance of the deficit in ceramides in the SC to impair the cutaneous permeability barrier was evidenced by the clinical observations that TEWL assessed in AD nonlesional skin increases inversely with the decreased levels of ceramides in the SC from the same skin site of AD patients [15, 16]. Further, the impaired
Alternative Mechanisms of Ceramide Deficiency The impaired barrier function of the stratum corneum in AD has been found to result from the decreased production of ceramides which are generated from sphingomyelin and glucosylceramide via enzymatic 67
reaction by aSMase and BGCase, respectively, in the healthy epidermis. Nevertheless, there is no abnormality in activities of both the enzymes and ceramide-degradative enzyme, acid ceramidase (aCDase) in the AD epidermis [21,22]. Then, we have discovered that, instead, there is a significantly up-regulated expression of a novel sphingolipid metabolizing enzyme, termed sphingomyelin (SM) glucosylceramide (GCer) deacylase [22-24,], which hydrolyzes SM or GCer at the acyl site to yield their lysoforms sphingosylphosphorylcholine (SPC) or glucosylsphingosine (GSP) instead of ceramide, leading to the ceramide deficiency in the AD skin. Consistently, those reaction products (SPC and GSP) accumulate to a greater extent in the involved and uninvolved SC of AD skin compared with chronic eczema or contact dermatitis as well as HCs [11, 12]. Recently, SM/GCer deacylase has been purified to homogeneity from rat skin and was identified as the beta-subunit of aCDase which consists of alpha- and beta-subunits linked by two S-S bonds, breaking of which by dithiothreitol elicited the activity of SM/ GCer deacylase . The abnormality of ceramide biosynthesis in which inflammation generally accelerates ceramide production in the healthy skin, but not in the AD skin , may be reasonably accounted for by the marked inflammation-dependent expression of the novel sphingolipid metabolizing enzyme.
deficiency and the barrier disruption in AD , this hypothesis lacks reasonable biochemical mechanisms by which filaggrin mutations elicit barrier disruption. In fact, some reports  have contradictorily demonstrated that AD patients exhibit a reduced skin barrier function regardless of the filaggrin genotype, which suggests that other factors besides filaggrin loss-of-function mutations modulate skin barrier integrity. Further, it has been established that the barrier function, as evaluated by TEWL, occurs as an independent factor from skin hydration as evidenced by the facts that subjects with senile xerosis have severe dry skin in spite of the lack of barrier disruption  and that treatment of human skin with acetone/ether predominantly elicits dry skin without any increased TEWL . Thus, the mechanistic connection between filaggrin lossof-function mutations and barrier disruption has not been resolved and remains controversial. In a search to directly associate filaggrin mutations with barrier disruption, which is the typical atopic skin phenotype, it has recently been reported that filaggrin-null mice have no significant abnormality in barrier function or water content as evaluated by TEWL and conductance values, respectively, despite the fact that the levels of filaggrin-derived amino acids are markedly reduced in the SC although outside-in cutaneous permeability is disrupted . This suggests that filaggrin-derived amino acids have no distinct contribution to barrier function evaluated by TEWL as well as skin hydration measured by conductance value, which renders the filaggrin mutation mechanism as a predisposing factor of AD very complex. Another hypothesis that filaggrin mutations are also linked via an as yet unknown mechanism to decreased ceramide levels in the SC has been challenged and there is no clear relationship between ceramide levels in the SC and filaggrin mutations in AD patients [45, 46]. If mutations in the human filaggrin gene may provoke a barrier abnormality, yet additional acquired stressors might be necessary because the same mutations can result in a noninflammatory disorder, ichthyosis vulgaris. Further, DNA mutations, such as filaggrin mutations, should be highly involved in inherent skin phenotypes as a barrier abnormality.
Filaggrin Mutation and Barrier Disruption Recently, in association with the water deficiency as well as the barrier disruption in AD skin, prevalent and rare loss-of-function mutations in the gene encoding filaggrin have been identified as the cause of the genodermatosis ichthyosis vulgaris and were additionally reported to be an important pre-disposing factor for the development of AD [27-30]. The mutation pattern and frequency in the filaggrin gene in patients with AD or ichthyosis vulgaris was found to vary in different countries with 27% frequency in Japanese AD patients compared with 3.7% of Japanese HCs [31-36]. Consideration of FLG mutations as an important pre-disposing factor for AD is mainly based on the hypothesis that loss-of-function variants of filaggrin result in the down-regulated levels of its degradation products (amino acids) which are believed to serve in the barrier function due to increased skin hydration. Although there are several reports that support the qualitative relationship between loss-offunction mutations in the filaggrin gene or filaggrin
Mechanisms leading to the Continually Impaired Barrier Function due to Ceramide Deficiency Our clinical observations also demonstrated that the continued impaired barrier function due to ceramide deficiency is not inherent and is associated 68
with post-inflammatory events in infants with AD . These findings can reflect the atopic diathesis as a genotypic predisposition but are not consistent with loss-of function mutations in the filaggrin gene in AD which may represent only one facet of the atopic abnormalities. Thus, the evidence for the involvement of inflammation in the predisposition to the ceramide deficiency which results in impaired barrier function prompted us to determine the effects of evoked inflammation on barrier function and ceramide biosynthesis in the SC of AD patients. We used tape-stripping as an inducer of cutaneous acute inflammation to compare changes in the levels of barrier disruption and water content as well as of ceramides and sphingolipid enzyme activities between AD and HC during the barrier recovery process. A similar approach with tape-stripping has been challenged in Nieman Pick patients with aSMase deficiency, which showed that the delayed barrier recovery is mainly ascribed to the inherently downregulated levels of aSMase activity . Based on this evidence, if the alteration of some ceramidemetabolic enzymes or their associates are involved as causative factors in the continued barrier disruption of AD, this challenge would provide a deep insight into skin phenotypic changes in barrier function and ceramide content in the SC of AD patients in response to cutaneous inflammation as well as into unknown atopic diathetic factors which may be provoked following acute inflammation. Our result showed that in AD skin (n=38), there was delayed recovery kinetics of TEWL only on the first day during the 4 days after acute inflammation elicited by 20-40 times of tape-stripping compared with HC skin (n=38) . This abnormality in SC function was accompanied by an unchanged lower ceramide level expressed as Âľg/mg protein in the SC of patients with AD (n=27) despite the fact that a higher ceramide level in the SC of HC (n=17) was further significantly up-regulated at 4 days post-tape-stripping. In a parallel study, whereas BGCase activity at 4 days post-tape-stripping was significantly up-regulated in the SC of healthy control skin (n=18) compared with before tape-stripping, a similar level of BGCase activity remained unchanged in the SC of AD skin (n=21). These findings suggest a possible defect in sphingolipid-metabolic processing that generates ceramide in the interface between the SC and the epidermis of subjects with AD. Further, we concluded that the continued barrier abnormality due to ceramide deficiency in AD may be associated with atopic diathesis-related and acute inflammation-
sensitive altered homeostasis of ceramide-metabolic processing other than BGCase, aCDase and aSMase Clinical Efficacy of Ceramide as a Major Role for AD Genesis Finally, to provide deep insight into the impaired barrier mechanisms which are associated with either ceramide or filaggrin-derived water soluble materials (mainly amino acids), it is of considerable interest to determine whether compensating either ceramides or water soluble materials may replenish the barrier function in in clinically normal, nonlesional skin of patients with AD, and this approach seems to be a key for preventing the refractory nature of the dermatitis and further to give a mechanistic insight into the AD genesis. To determine whether the disrupted barrier function of AD nonlesional skin can be repaired by topical application of either ceramides or water soluble materials, we applied topically a synthetic ceramide (CER: 8%) or hirudoid (HIRU)-containing cream to the nonlesional skin of AD patients for 4 weeks and evaluated their efficacy by measuring TEWL and capacitance values as well as clinical scoring for scaling/dryness/itchiness . Treatment for 4 weeks with the CER cream significantly reduced dryness/ scaling/itchiness which was accompanied by significant decreases in TEWL and increases in capacitance values at 2 and 4 weeks. In contrast, treatment for 4 weeks with the HIRU cream elicited a similar but lesser reduction in dryness/scaling/itchiness which was accompanied by significant but lesser decreases and increases in TEWL and capacitance values, respectively, at 2 and 4 weeks. Comparison of TEWL and capacitance values during the 4 weeks of treatment with CER or HIRU creams revealed that while the two parameters of CER cream-treated skin became generally similar to healthy control skin, those of the HIRU cream-treated skin remained similar to mild or moderate AD skin. The efficacy for barrier recovery by ceramide application was also evidenced by the fact that, while MA applied under an occlusive condition can easily penetrate the dermis of the clinical normal skin of AD patients, the pre-application of synthetic ceramides definitely abolished the MA penetration, resulting in a marked reduction of mite-dependent cutaneous allergic reactions compared with nonapplied skin. Taken together, our clinical efficacy using synthetic ceramides at relatively higher concentrations, focusing on barrier replenishment, provides a deep insight into pathogenesis of AD as a ceramidedeficient disease.
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Luncheon Symposium and Forum Sun. May 12:00~13:30
LCS1 Shaw Han Luncheon Symposium 12:10 Room 303A
body. Results will be shared from a recent study evaluating cryolipolysis for reduction of inner thigh fat. The new CoolFit™ flat cup vacuum applicator will be introduced and its safety and efficacy will be demonstrated. Interim results for cryolipolysis of the inner thighs indicate that visible reduction of inner thigh contour was achieved. Three blinded, independent physician reviewers unanimously identified baseline photos for all study subjects. Mean fat layer reduction at 2 months was 23.6% and mean circumferential reduction at 4 months was 1.7 cm. Cryolipolysis for treatment of pseudogynecomastia will also be discussed. This benign enlargement of the male breast due to excess sub-areolar fat can cause significant psychological distress and embarrassment, particularly in adolescents and young men. The excess fat in male breasts is typically treated by surgical excision or liposuction, but the condition has been safely and effectively treated by cryolipolysis in a recent clinical study. Patient surveys revealed high satisfaction and procedural tolerability. Modest reduction of fat in the male breast was found to produce significant improvement in quality of life. Finally, the Treatment to Transformation (T2T) protocol will be presented. T2T is a breakthrough method of assessing and contouring the whole body rather than simply treating discrete fat bulges. The T2T concept has revolutionized non-surgical body contouring, producing enhanced clinical outcomes and high patient satisfaction. With careful treatment planning, multiple cycles, and proper applicator placement technique, T2T non-invasive body contouring results can rival liposuction. Before/after photographs, patient survey results, and ultrasound fat layer measurements will be presented to illustrate efficacy.
Brian Zelickson, MD Speaker Moderator Tsung-Hua Tsai, MD, MSc
What’s New and Next in Aesthetic Dermatology Part 2: Non-Invasive Fat Reduction Keywords: CoolSculpting, cryolipolysis, body contouring, injectable lipolysis, neuromodulators, Botox alternatives, topical Botox, cryo denervation, focused cold therapy, tattoo removal, perfluorodecalin, PFD patch, R-20 method Introduction The aesthetic dermatology industry continues to grow rapidly as consumers seek the newest methods to reduce the signs of aging. Aesthetic procedures are gaining popularity and various new technologies are available to rejuvenate faces and contour bodies. This presentation will review the latest advancements in non-invasive and minimally-invasive fat reduction, including CoolSculpting®, the only FDA-cleared non-invasive procedure to safely and effectively eliminate localized fat by cooling. The newest advancements in tattoo removal, injectable lipolysis, and neuromodulators will be shared. Part 2: Non-Invasive Fat Reduction While minimally-invasive fat reduction is a hot topic, non-invasive fat reduction is an even cooler one. CoolSculpting is an established and well-accepted procedure for non-surgical body contouring. Based on cryolipolysis technology exclusively licensed from Harvard University-affiliated Massachusetts General Hospital, CoolSculpting reduces subcutaneous fat without harming skin or other surrounding tissues. The CoolSculpting system and treatment methodology will be discussed. Cryolipolysis treatment can be applied to a variety of anatomical sites, such as the abdomen, flanks, backs, and thighs. Results have proven to be both durable and consistent, with almost 600,000 treatments worldwide. Recent clinical results will be presented, including cryolipolysis for treatment of inner thighs, pseudogynecomastia, and the whole
Conclusion A variety of the latest procedures in aesthetic dermatology will be presented, including topical neuromodulators, injection lipolysis, R-20 PFD patch tattoo removal, and cryogenic denervation. For body contouring, CoolSculpting will be demonstrated as a safe and effective non-surgical method for reduction of fat in the abdomen and flanks, as well as the whole body.
Invida Luncheon Symposium
MSD Luncheon Symposium
Adelaide Hebert, MD Speaker Moderator Tzu-Kai Lin, MD
Jerry Shapiro, MD Director Moderators Ren-Yeu Tsai, MD Jung Yi, Chan, M.D.
Atopic Dermatitis: Novel Non-steroidal Skin Barrier Therapy
How to Approach Female Patients with Hair Loss
Atopic dermatitis is a common skin disorder that primarily affects children. Characterized by a chronic relapsing course, pruritus, and typical anatomic locations of spongiotic dermatitis, finding the optimized skin care regimen can prove challenging. New understanding of the basic science and genetics that underlie the causations of atopic dermatitis have helped guide new non steroidal skin barrier therapy. This discussion will focus on the background leading up to the current regimens for barrier repair. Review of certain basic science tenants will help align therapeutic recommendations with practical and affordable interventions that help reduce the burden of disease and improve the quality of life for patient suffering with atopic dermatitis.
Female pattern hair loss (FPHL) is the most common cause of hair loss in women. It has a greater psychosocial morbidity than that of male pattern hair loss (MAGA). Clinical presentation of FPHL is quiet distinctive with most of hair thinning is usually confined to the crown region of the scalp. Frontal hair line is usually spared; however, it might be affected in some patients. Miniaturization of terminal scalp hair and shortening of anagen growth phase of the hair cycle results in growth of thinner and shorter hair fibers. Diagnosis is usually made clinically. Recent advances in digital image analysis has consistently increased the use of the dermatoscopy in the diagnosis of FPHL and, as a consequence, reduced the need for doing a skin biopsy. Many medical and surgical treatments are currently available with various success rates. We will discuss the major recent advances in the diagnosis and management of FPHL.
Luncheon Forum and Symposium Register and join the forum or symposium during lunch time! Advanced registration is required for admission and lunch boxes will be provided. Aesthetic Dermatology: Non-invasive Fat Reduction @Room 303B Atopic Dermatitis: Skin Barrier Therapy, 12:45~13:25@Room 303B
Psoriasis Forum, 12:00~13:20@Room 303A
Injection: Volumetric Full-Face Reshaping, 12:15~13:15@Room 403
Hair: Female Hair Loss, 12:30~13:20@Room 407
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Luncheon Symposium and Forum Sun. May 12:00~13:30
LCS4 MERZ Luncheon Symposium
volume restoration in the rejuvenation of the aging face.
12:15 Room 403
Speakers Nark-Kyoung Rho, MD, Hema Sundaram, MD Moderator Yates Yen-Yu Chao, MD
Aging changes in the midface include volume loss from hard and soft tissue changes as well as the descent of the SOOF (superficial orbicularis oculi fat) and malar fat complex. With age, significant changes occur in the central third of the face. The malar fat pad is the focus of the central third of the face. As the fat pad descends, changes occur that characterize the aging face. These changes produce midfacial hollowing and a gaunt appearance, starting as early as in the early 30’s of the patient’s age. Filler injection in the midface has many advantages for the doctor and patient including ease of placement, avoidance of surgery, adjustability, and the ability to individualize and custom contour for each patient. One problem that can exist with midfacial filler augmentation is the decision where to exactly place the filler or how much filler to place. In this context, it is very important to understand the midface fat compartments and distinct anatomic structures providing attachments and support for the soft tissues of the central third of the face.
Volumetric Full-facial Reshaping: Expanding the Use of Radiesse to Restore Youthful Fullness to the Face Nark-Kyoung Rho, MD T h e c a u s e s o f f a c i a l a g i n g i n c l u d e g r a v i t y, photodamage, soft tissue maturation, skeletal remodeling, and muscle activity. In the thirties, periorbital and perioral wrinkles and fine lines develop and the eyelids begin to sag. In the forties to sixties, the tip of the nose drops, the jawline begins to sag, and skin on the neck becomes lax. Volume loss and muscular hyperactivity are two major components in the aging process that together contribute to the formation of wrinkles. Therefore, the treatment of both processes will produce a more natural and refined outcome. Not to mention of the chemical peels, ablative or non-ablative laser resurfacing, and traditional surgical face lifting, combined use of injectable fillers and botulinum toxin poses an advantage over a single modality treatment. With fillers, deflated facial soft tissue volume is restored. With botulinum toxin, hyperactive muscle movement is controlled. Each targets a specific property of facial aging in different ways, which makes the combination a highly effective, logical, dual-step approach in reshaping and contouring the face.
With aging, the muscles and fat of the temporal area wate away and we gradually see the fullness of the temporal region disappear, making way for a more prominent hollw, bounded by the orbital and zygomatic bony prominences. The correction of this area using volumizing fillers harmonized the treatment of various aesthetic units, offering a homogenous and healthy look. We can restore youthful fullness of the face with injectable volumizing fillers. Generally speaking, the more imperceptible the boundaries of a face are, the younger the face appears. This area is not a difficult area to augment if an injector knows the anatomical structure of the temporal fossae, namely, various layers, muscular characteristics, the depth, location, and distribution of vessels and nerves. Of course, proper injection technique should be addressed to get the best clinical results. Apart from the mid-cheek groove and temporal hollowing, nose and chin pose a great importance in making a more prominent, refreshing, and harmonized look. Chin reshaping and nose bridge augmentation are most frequently done, probably, in East Asian countries such as Korea, Japan, and most remarkable, Taiwan. If nose or chin reshaping
Volume restoration is an important aspect in facial rejuvenation and clients are increasingly seeking noninvasive approaches to facial enhancement. Injectable fillers are an excellent alternative for anti-aging treatment of the face, with a minimal recovery time. Traditionally, injectable fillers were mainly indicated for the correction of nasolabial folds, marionette lines, glabellar frown lines, etc., whereas autologous fat have always been a mainstay of reproducing youthful facial contours. In recent days, thanks to the new filler technology, contemporary cosmetic surgeons are now using various “volumizers” with the concept of 76
is performed with augmentation of the other parts of the face, especially midface and jawline, its clinical outcome will be doubled. Forehead is a tricky area to reshape using injectable fillers. If a physician performs the procedure with proper techniques (e.g., subgaleal placement using microcannulas) with very meticulous approach on the forehead, the patientsâ€™ satisfaction will be higher.
JENSSEN Psoriasis Luncheon Forum
In this lecture, the lecturer will focus on the anatomy and aging changes of bones, fat pads and other softtissue structures that control mobilization of the mid- and lower face. The anatomic relationship of these structures explains the visible effect of aging in the face and correlates with the outcomes of surgical rejuvenation as demonstrated in clinical cases. Also, direct physical, chemical, and rheological characteristic of Radieese product will be presented to help physicians to choose the proper technique using this calcium hydroxylapatite product for full facial reshaping.
This session will focus on different aspects of psoriasis in Taiwan with emphasis on interactions between panelists and participants. The main focuses of this session include physician viewpoints on different prescription formulations (topical and systemic) and possible adverse events related to different treatment options. The session will be modulated by Dr. Steve Feldman from Wake Forest University, USA, and Dr. Cheng-Che Lan from Kaohsiung Medical University, Taiwan. A group of experts on psoriasis including Dr. Yi-Ju Chen, Dr. Ji-Chen Ho, Dr. Yu-Huei Huang, and Dr. Tsen-Fang Tsai will act as panelists for this forum. The event will start with a brief overview regarding the current status of psoriasis in Taiwan and be followed by full-house discussion regarding relevant issues on management of psoriasis among panelists and participants. A mind-stimulating interactive session is fully expected.
Moderators Steven Feldman, MD, PhD, Cheng-Che E. Lan, MD, PhD Panelists Yi-Ju Chen, MD, PhD, Ji-Chen Ho, MD, Yu-Huei Huang, MD , Tsen-Fang Tsai, MD
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Lasers Symposium
Sun. May 5, 13:30~17:00 LS1 Lasers, Light and Radiofrequency Devices for Facial Rejuvenation on Asian Skin – An Update
Speakers Chee-Leok Goh, MD, MBBS Henry Chan, MD, PhD Arie Benchetrit, MD Ronald Moy, MD Nark-Kyoung Rho, MD Sam-Shik Shin, MD Kyu-Kwang Whang, MD, PhD
Speaker Chee-Leok Goh, MD, MBBS
Facial acne scars can cause physical, emotional distress and affects quality of life. The treatment of acne scars depend on the types of scars present. Very often a combination of treatment modalities are used to achieve optimal outcome. Ablative laser devices are associated with long recovery times and adverse effects such as postinflammatory hyperpigmentation and scaring. Nonablative has minimal downtime, but often ineffective. Currently, fractional laser (non-ablative and ablative) resurfacing is the most commonly used procedure because it is fairly effective and has few side effects, but requires multiple treatments to achieve acceptable outcomes. Fractional lasers produce patterns of tiny thermal wounds surrounded by undamaged tissue where cells act as a reservoir for rapid healing. A treatment called ‘ sublative rejuvenation™ ’ with fractional bipolar radiofrequency (RF) energy has recently been shown to improve acne scars, mild rhytids, skin texture and skin tightening with little downtime. This fractional delivery of RF energy causes micro-epidermal ablative injuries with wider spread dermal coagulation. This initiates a wound healing response in the dermal matrix associated with minimal damage to the epidermis. Less affected tissue surrounding the matrix points may be stimulated by heat which helps accelerate the healing process. With this treatment modality only 5% of the epidermis is affected compared to 10 – 70% with fractional ablative laser treatments.
Directors Henry Chan, MD, PhD, Chih-Hsiun Yang, MD
LS1 Lasers, Light and Radiofrequency 13:30 Devices for Facial Rejuvenation on Asian Skin – An Update / Chee-Leok Goh, MD, MBBS LS2 High Intensity Focused Ultrasound 14:00 for Non-invasive Body Contouring / Henry Chan, MD, PhD LS3 Nonsurgical Body Contouring with 14:30 Focused Ultrasound / Arie Benchetrit, MD LS4 The Benefits of Dual Wavelength 15:00 Technology for The Treatment of Vascular Lesions and Pigmented Lesions / Ronald Moy, MD LS5 Using a Novel Microwave Energy 15:30 Device for a Non-invasive, Lasting Solution to Axillary Hyperhidrosis / Nark-Kyoung Rho, MD LS6 Melasma Treatment Using Large 16:00 Spot-size KTP Laser / Sam-Shik Shin, MD LS7 Introducing Micro-focused 16:30 Ultrasound for Non-Invasive Face Lifting / Kyu-Kwang Whang, MD, PhD
eTwo™ is a fractionated radio frequency device that combines the Sublime™ controlled heating and Sublative™ fractional skin treatment for skin rejuvenation. The Sublime™ infrared light and bipolar radio frequency causes remodeling of the deep dermal layer of the skin by stimulating new collagen growth. The Sublative™ fractionated bi-polar radio frequency technology places heat energy in the upper layers of the dermis allowing for a significant increase in collagen and elastin production. The Sublime™ application carries minimal downtime and the Sublative™ application is associated with minimal downtime with crusting and erythema that lasts about
LS2 High Intensity Focused Ultrasound for Non-invasive Body Con
2-3 days. It has been reported to be safe on skin type V and VI. Reports indicated that fractional bipolar RF energy is a safe and effective treatment of acne scars. In one report acne severity was significantly lower than baseline at the 1-month and 3-month followup visits, global scores were significantly reduced at the 3-month follow-up visit, and improvement in cosmetic appearance was significant at the 1- and 3-month follow-up visits. Dryness, bruising and crusting/erosion were absent. In another report, satisfaction rate was 67 – 92% of subjects.
Speaker Henry Chan, MD, PhD Background and Objectives High-intensity focused ultrasound (HIFU) is a noninvasive technology for body contouring. HIFU is focused within the subcutaneous adipose tissue, causing coagulative necrosis and cell death. The objective of this study is to evaluate the effectiveness of a HIFU device for sculpting of the abdomen. Materials and methods The system has a set focal depth of 1.3cm. 12 subjects with adipose thickness no less than 2.5cm who met the screening criteria were recruited. Each subject received one treatment to the abdomen. The total fluence used per site was 150-165J/cm2 with a mean of 161J/cm2. The waist circumference at iliac crest and the point of maximum circumference were recorded at baseline, 4, 8 and 12 weeks post-treatment, as well as their weight and BMI. Subjects’ rating on comfort level and satisfaction were collected via questionnaires at every follow-up. Standardized photographs were also taken with the Canfield System ® at each visit.
藝術與人文茶道 的對話 馮建洲 老師 Ancient people described fine tea as: 〝Subtle and far-reaching,theUniversal energy from a cup of tea.〞 〝Subtle and far-reaching,〞the taste takes us to another realm 〝The Universal energy〞penetrates your whole body.
Results 7 out of 12 subjects were satisfied with the outcome and 9 out of 12 would recommend this treatment to their friends and family. There was statistically significant improvement in the waist circumference measured at both the iliac crest (p-value 0.013, 0.002, 0.005) and maximum waistline (p-value 0.003, 0.034, 0.023) at 4, 8, 12 weeks post-treatment. Spearman’s rho for correlation of energy level vs. improvement showed that at 12 weeks post-treatment follow-up, the improvement significantly correlated with the total fluence per treatment (p-value 0.041). The higher the total fluence delivered, the larger the decrease in waist circumference.
Harmonize and release,body and spirit Metamorphose，become an Immortal. Simple though not rough,the tea utensils, Composed amd natural. the host, From limited to boundless, the guest, From sentiment to spirit Gradually,opening to the ommipresent Universe That is our Soul.
Conclusions High-intensity focused ultrasound effectively decreases waist circumference in Chinese. The higher the total fluence delivered, the larger the decrease in waist circumference was observ 禪那人文空間
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Lasers Symposium
Sun. May 5, 13:30~17:00 LS4 The Benefits of Dual Wavelength Technology for The Treatment of Vascular Lesions and Pigmented Lesions
LS3 Nonsurgical Body Contouring with Focused Ultrasound Speaker Arie Benchetrit, MD
Speaker Ronald Moy, MD
The desire to improve body contours and to remove unwanted fat is highly prevalent amongst patients and physicians. However, the risks, discomfort and downtime associated with the traditional invasive procedures used to achieve these goals have motivated many patients and physicians to look at non-surgical options. A novel device using non-thermal selective focused ultrasound for non-invasive lipolysis and body contouring has been developed (UltraShape) and used on over 300,000 patients worldwide. This device has been the object of several peer-reviewed studies published in scientific journals.
Dual wavelength lasers with the pulsed dye laser (PDL) combined with the Nd:YAG are more effective at treating vascular lesions than the standard PDL alone. With the sequential emission of the wavelengths, the Nd:YAG laser treats the deeper vascular lesion while the PDL treats the more superficial vascular lesions. Dr. Moy will present the utilization of dual wavelength PDL and Nd:YAG laser treatment of port wine stains, hemangiomas, telangiectasias, leg telangiectasias, leg veins, lentigos and a variety of vascular lesions. Dual wavelength delivery has become increasingly popular in laser technology, and proves advantageous in other applications such as laser lipolysis and laser hair removal.
The aim of this presentation is to review the physics of focused ultrasound and its role in noninvasive lipolysis and body contouring, comparing thermal and non-thermal modalities as well as other competing technologies Scientific evidence will be presented demonstrating non-invasive selective fat cell destruction while sparing surrounding critical structures. The relevant studies will be examined, as will the presenter’s 5 ½ year personal experience and clinical results with the UltraShape device through its evolutionary changes.
皮膚醫學中文口譯 口譯場次： ◎大會演講Plenary Lectures(PL1~5)： 5月5日8:40~12:00 ◎KAO研究所所長Genji Imokawa 教授特別演講(ES8)：5月5日11:00~12:00 ◎雷射研討會(LS1~7)：5月5日13:30~17:00
LS5 Using a Novel Microwave Energy Device for a Non-invasive, Lasting Solution to Axillary Hyperhidrosis
ablation of tissue. Because eccrine sweat glands and ducts hold significant amount of water inside, the microwave energy generates more heat in the sweat glands with a relative selectivity. The device consists of three components: 1) a console, composed of a chiller, vacuum pump, and custom software that controls energy delivery; 2) a handpiece, which delivers a 1 cm x 3 cm zone of therapy and contains four microwave antennas as well as active cooling to protect the dermis; and 3) a sterile and disposable vacuum tip that lifts skin from the underlying structures and stabilizes tissue during the therapy cycle.
Speaker Nark-Kyoung Rho, MD Hyperhidrosis, a disorder of excessive sweat, may be focal, involving specific areas of the body, or generalized, involving the entire body. Focal hyperhidrosis most commonly affects the axillae, hands, feet, and face. Among them, axillary hyperhidrosis is the most common and embarrassing condition, especially in Asian culture. Axillary hyperhidrosis may have significant effects on patientsâ€™ lives including social embarrassment; interference with intimacy, activities of daily living, and certain kinds of employment; and physical discomfort and a negative impact on health-related quality of life (QOL). There are numerous therapeutic modalities, but none has proved entirely satisfactory, including topical or systemic medication, botulinum toxin injection, various surgical procedures. Surgical treatments include transthoracic endoscopic sympathectomy, local excision, curettage, shaving or defatting to remove axillary secretion glands and subcutaneous fat. Each modality has its ups and downs. Topical treatment is cheap and easy to apply but very shortacting and less effective. Botulinum toxin injection is simple and effective but relatively short-acting for months and not cost-effective. Surgical treatment has been shown to be near permanent and highly effective clinical outcomes, whereas it is related with significant downtime and patient discomfort. Also, complications are not uncommon after aggressive surgical manimpulation of the axillae. Endoscopic thoracic sympathectomy is invasive and may lead to Hornerâ€™s syndrome, pneumothorax, hemothorax, gustatory sweating, and compensatory hyperhidrosis.
After identifying the areas of excessive sweating (usually the entire hair bearing area) and then a proper-sized template is used to mark out a treatment grid. Before treatment, local injection of lidocaine (with or without epinephrine) should be performed first. After administering local anesthesia, the operator moves the handpiece from zone to zone in a specified pattern until the entire hyperhidrotic area is treated. The procedure typically lasts 60-75 minutes, depending on the size of treatment area. One treatment session is enough for the majority of cases. However, in some patients with severe hyperhidrosis or osmidrosis, two procedures with 3~4 months interval are required for optimal results. Studies of the effectiveness and safety of the treatment have been reported. A pre-approval, randomized, blinded, controlled study on 120 patients at seven centers resulted in 89 percent of severely hyperhidrotic subjects reaching a level of 1 or 2 on the Hyperhidrosis Disease Severity Scale (HDSS) at one month post-treatment. Sixty-nine percent maintained this effect at one year follow-up visit. Treatment side effects were mild and transitory. Swelling and bruising are inevitable after treatment and may persist for several days to 1~2 week(s). The most common patient complaint was temporary altered sensation in the skin. A post-approval, open label clinical trial of 31 hyperhidrotic subjects followed for 12 months showed that over 90 percent of subjects demonstrated a reduction of HDSS to level 1 or 2 at 12 months. The average gravimetric reduction in sweat was 81.7 percent at one year post treatment, and 85.2 percent reported a greater than five-point reduction in the quality of life index. Most patients reported loss and thing of axillary hairs, which the female subjects
In this lecture, the lecturer will present a novel system for axillary hyperhidrosis using a microwave energy. The system, MiraDry is a non-invasive, office-based procedure that received US Food and Drug Administration (FDA) clearance in 2011 for treatment of excessive axillary hyperhidrosis. This novel device delivers microwave energy to the dermalfat interface to destroy sweat glands. Continuous hydroceramic cooling prevents thermal conduction of heat superficially and creates a focal thermal zone at the level of sweat glands, resulting in targeted
SCIENTIFIC SESSIONS SUNDAY, MAY 5 Lasers Symposium
Sun. May 5, 13:30~17:00 LS6 Melasma Treatment Using Large Spotsize KTP Laser
actually appreciated. The side effect profile was similar to that seen in the previous study, although one patient reported a treatment-related triceps neuropathy, which was resolving at six months when she was lost to follow up. Clinical experience gathered since commercial release of the system confirms the results of these two published studies. The clinical efficacy of the novel microwave system on axillary sweating was confirmed histopathologically. Axillary biopsies as early as 11 days post-treatment demonstrated eccrine and apocrine gland cells devoid of nuclei as well as complete cellular necrosis. At six months, histology confirmed a complete absence of sweat glands in the treated area. Apart from the sweating, axillary odor (osmidrosis) is another major concern for many East Asian people. Current standard treatment for axillary osmidrosis involves liposuction combined with dermal curettage which has advantage over simple liposuction alone because superficial liposuction could remove only the subcutaneous fat without sweat glands in the lower dermis. However, the use of such aggressive instruments is associated with significant downtime and higher rate of hematoma formation because the procedure induces rather extensive trauma to the subcutaneous tissue and deep dermis with injury to the dermal vascular plexus. The efficacy of botulinum toxin on axillary odor has not been fully evaluated. The novel microwave sweat gland ablation treatment has been used to treat severe axillary osmidrosis in Japan. Though there have been no scientific articles published until now, Japanese researchers have found that this system can be used to treat axillary odorous sweating, too. It is a general consensus of Japanese and Korean researchers that axillary osmidrosis treatment requires higher energy setting when compared to the treatment of axillary hyperhidrosis without odor and a second “touch–up” procedure is required in the majority of cases. The lecturer hopes this condition to be intensely studied in Taiwan after the launching of the novel microwave system.
Speaker Sam-Shik Shin, MD Melasma is a difficult to treat chronic skin condition that often presents with both vascular and pigment problems. Lasers have had mixed success treating melasma. Although melasma symptoms can significantly be improved after vascular and pigment treatment, excess thermal effect can cause recurrence, burns hyperpigmentation or hypopigmentation. Therefore, care must be taken when treating melasma with lasers. The Excel V (Cutera Inc., Brisbane CA, USA) recently developed long pulsed 532/1064nm laser has an advantage of controlling pulse duration of 532nm wavelength laser, enabling users to treat vascular and melasma treatments simultaneously. Additionally, this laser system causes less thermal damage than traditional 532nm lasers such as the Gemini (IRIDEX Inc., Mountain View, CA, USA) which helps prevent the recurrence of melasma. So, why does traditional 532nm wavelength laser not to have this effect? The traditional 532nm laser is continuous wave (CW) type laser that has long pulse width with very strong thermal effect and that still generates thermal damage even when fluence is reduced, and even though the pulse peak power of traditional 532nm laser does not go higher than new 532nm laser. This 532/1064nm laser, flash lamp type laser, is capable of producing high peak power not only on very short pulse width, but also on long pulse width. There are diverse factors that cause melasma therefore it is not easy to treat it. Patients were satisfied when treatments of local vascularity and pigment were conducted, which are deemed the main two factors causing melasma, and full face skin tone treatment. Merely treating melasma could be possible with other laser devices. However unlike most other devices, the rate of recurrence of melasma was much less with this new developed 532/1064nm laser and patients were more satisfied with results when treated with this laser than when treated with other devices.
我們努力讓 台灣看見世界 更希望 世界看見台灣
LS7 Melasma Treatment Using Large Spotsize KTP Laser Speaker Kyu-Kwang Whang, MD, PhD
High intensity microfocused ultrasound Ulthera@ is expanding to be used for consistent significant lifting of upper and lower face tissue in a broad range of patients. Extensive research pipeline support expanded indications i.e. face, upper eyelid & neck lift, lower eyelid tightening& the improvement of dark circle, breast lift, body tightening and axillary hyperhidrosis etc. Advantage of ultherapy is no need to incision, therefore, no bleeding, no downtime, safe to expose to sun immediately after procedure. Main target of ultherapy was deep dermis and fascia especially retaining ligaments which make the skin firm and lifted effectively. It also revealed the upward elevation of fat sagging, and producing the mandibular V line(Nefertiti line). High intensity microfocused ultrasound can make fat atrophic, which makes mild lower bulged eyelid fat reduced, and means not to do on atrophic area due to skin aging. Vector of direction of lines can also affect the results.
籌備委員會製作海報至 ICAD 2013 - 4th International Congress in Aesthetic Dermatology 會議所在地泰國曼谷發送海報。
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In respect to skin anti-aging, ultherapy works as like main H beam of the building construction, and other anti-aging procedures like radiofrequency, botox and filler will work synergistically for fine refinements. It can also contribute to prevent the future aging process by stabilizations of aging skin structures. I will explain strategies like ‘Double U, W Theory,’(Whang’s suggestions) for better understanding and performance of ultherapy in this lecture.
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SCIENTIFIC SESSIONS SUNDAY, MAY 5 Adjuvant Therapy in Dermatology Symposium Sun. May 5, 13:30~14:30
AS1 What’s New in Anti-aging Skin Care –DNAEGF
Director Pin-Chi Chiu, MD, MBA
Speaker Ronald Moy, MD
AS1 What’s New in Anti-aging Skin Care 13:30 –DNAEGF / Ronald Moy, MD AS2 Management of Melasma and 14:00 Hypermelanosis with Topical Tranexamic Acid-based Therapy / Kuo-Hsien Wang, MD,MS
Skin Tightening with EGF, FGF creams and DNA Repair Enzyme Creams Aging of the skin is associated with thinning and looseness. Improving the appearance of aging skin includes increasing the thickness of the skin which results in the appearance of tighter skin. Skin tightening can occur with stimulation of fibroblasts and myo-fibroblasts to produce collagen, thicken skin and the tighten skin. Creams containing DNA repair enzymes in liposomes have been shown in clinical studies to repair damaged DNA(also decrease actinic keratosis) in the skin but also to increase collagen production. Human Epidermal Growth Factor( EGF )and Fibroblast Growth Factor (FGF ) which are both bio-engineered from barley instead of E. coli bacteria increases collagen production causing skin thickening, tightening and lifting. Topical human EGF has also been shown in clinical studies to tighten pores, improve pigmentary blotchiness and improve wrinkles. Human EGF and FGF stimulates epidermal stem cell which thickens, tightens and renews skin
AS2 Management of Melasma and Hyper/ melanosis with Topical Tranexamic Acid-based Therapy
Speaker Kuo-Hsien Wang, MD,MS
Taiwanese Dermatological Association
學會近期活動 Melasma is an acquired hypermelanosis commonly seen in Asians. Although ablative lasers, nonablative fractional lasers, Q-switched Nd: YAG lasers, superficial peeling, as well as topical hydroquinone (HQ)-based therapy have been used to treat melasma with variable effects, it remains a difficult-to-treat condition. Efficacy of HQ is directly linked to concentration, but the incidence of adverse effects also increases with concentration. These include skin irritation, phototoxic reactions, secondary postinflammatory hyperpigmentation, and rarely, irreversible exogenous ochronosis. Triple combination therapy with HQ, tretinoin and fluocinolone was found in one study to be faster and more effective in reducing melasma than HQ. However, it also carries an increased risk of adverse reaction than HQ alone. Tranexamic acid (TA), a hemostatic agent, has been found in Japan to block the prostaglandin E2 which in turn inhibits the weak inflammation and production of melanin. It appears to be a promising topical agent to treat melasma and other pigment blemishes on the skin. Topical TA combined with two other supportive whitening/anti-inflammatory agents (Transino) is widely used in Japan to treat many forms of skin blemishes. In the talk, we will present our treatment results and share experiences of Transino on the management of melasma and other melanosis, as well as introduction of the new product of Transino Whitening Day Protector.
「青春痘卓越門診」計劃 「異位性皮膚炎卓越門診」計劃 詳見學會網頁公告，敬邀會員踴躍參與
桃竹苗區皮膚科醫師繼續教育 乾癬與性病門診品質提升活動 日期：102年5月26日(日) 地點：新竹國賓飯店13F AB會議室 指導單位：行政院衛生署疾病管制局 主辦單位: 臺灣皮膚科醫學會 限本會會員、準會員免費參加，請事先報名 報名截止日5月17日，詳見學會網頁公告
臺灣皮膚科醫學會第39屆年會 暨學術研討會 8th International Congress on Cutaneous Adverse Drug Reactions
SCIENTIFIC SESSIONS SUNDAY, MAY 5 護理師、諮詢師與醫師助理訓練課程 Sun. May 5, 14:30~16:30
Speaker 邱品齊醫師 Moderator 楊國材醫師
(TC1) 14:30 1. 認識化妝品與藥妝品 (TC2) 15:10 2. 認識果酸及維他命C (TC3) 15:50 3. 雷射治療術後護理簡介 近十年來， 隨著整體化妝品產業的升級、生 物科技的發展，以及社會大眾對於化妝保養品的 高度期待，讓含有果酸、左旋C、玻尿酸及各種抗 氧化成分的產品風行全球，於是藥妝品反而成為 化妝保養品界當紅的概念。在國外，結合化妝品 學（cosmeticology）、皮膚科學（dermatology）及 藥理學（pharmaceutics）所形成的藥妝品皮膚科學 （cosmeceutical dermatology），甚至成為近年來新興的 皮膚學科，越來越受重視。本次演講將先從認識藥妝 品開始，並深入探討在臨床上常用的果酸及維他命C 背後的真相以及雷射術後要如何護理才能相輔相成。 也希望藉由此次演講，可以讓大家更了解藥妝品皮膚 科學對於皮膚科醫師及臨床治療的重要性。 參考文獻: 1. Procedures in Cosmetic Dermatology Series: Cosmeceuticals,Second Edition Zoe Diana Draelos, 2008 2. Cosmetic Dermatology: Principles and Practice,Second Edition Leslie Baumann, 2009 3. 藥妝品–認識你所不知道的藥妝品(大境出版社) 邱品齊, 2010 4. 幸福美肌–一輩子就買這一本 (時報出版社) 邱品齊, 2013 5. 化妝品真相大公開社群網站: http://tw.myblog.yahoo.com/skindocchiucosmeticfact/
Arie Benchetrit, FRCS (C) Dr. Arie Benchetrit is a certified Plastic Surgeon, specializing in cosmetic surgery and lasers. Dr. Benchetrit graduated from medical school at the Université de Montreal and then attended McGill University where he completed his specialty training in both General Surgery and Plastic Surgery. He has been in practice as a Plastic Surgeon in Pointe Claire since 1990 and is on staff at the Lakeshore General Hospital. Dr. Benchetrit is also the Medical Director of the Cosmedica clinic in Montreal, Canada, which offers the full range of surgical and non-invasive facial and body rejuvenation procedures. Dr. Benchetrit is a Fellow of the Royal College of Surgeons of Canada in both General Surgery and Plastic Surgery. Among his many memberships, he is a member of the American Society for Aesthetic Plastic Surgery, The Canadian Society of Plastic Surgeons and is the current President of the Canadian Laser Aesthetic Surgery Society. Dr. Benchetrit is recognized as a leading expert in the field of cosmetic surgery and cutting-edge aesthetic procedures and has published and presented on these subjects at scientific meetings in North America, Europe and Asia.
Yen Yu Yates Chao(趙彥宇 ), MD Director, Chao and Chiu Institute of Dermatology, Taipei Frequent lecturer in international congresses and the invited speaker of ASEF, Seoul and MAPES, Macau Advisor and physician trainer for leading manufacturers of laser devices and cosmetic injectables The innovator of several novel injection techniq
Chien-Hsun Chen (陳建勳 ), MD Chief, Hair Transplant Center, Chang Gung Memorial Hospital , Taipei Attending Dermatologic Surgeon, Department of Dermatology, Chang Gung Memorial Hospital, Taipei
Henry Chan, MD, PhD
WenChieh Chen, MD, Dr.med. (Germany)
President, Hong Kong College of Dermatologists, 2012 Honorary Professor, University of Hong Kong Former Head of Dermatology, Hong Kong University Honorary Clinical Associate Professor, Chinese University of Hong Kong Visiting Scientist and Associate Clinical Professor, Wellman Center for Photomedicine, Harvard Medical School Fellow of the Royal College of Physicians (FRCP) London, Edinburgh, and G
Associate Professor, Department of Dermatology and Allergy, Technical University Munich, Munich, Germany Alexander von Humbold scholarship, Germany, 2007 Editorial board: European Journal of Dermatology, Dermato-Endocrinology, Dermatologica Sinica
Yi-Ju Chen(陳怡如 ) , MD, PhD
Hsien-Ching Chiu (邱顯清 ), MD
Assistant Professor, Faculty of Medicine, National Yang-Ming University, Taipei Attending Physician, Department of Dermatology, Taichung Veterans General Hospital PhD, School of Life Sciences, National Chung-Hsing University, Taichung Member, Board of directors, Taiwanese Dermatological Association
Chair, Department of Dermatology, National Taiwan University College of Medicine and National Taiwan University Hospital Associate Professor, Department of Dermatology, National Taiwan University College of Medicine M.D., National Taiwan University College of Medicine Research Fellow, Department of Dermatology, Stanford University School of Medicine, CA, USA
Ching-Chi Chi(紀景琪 ), MD, MMS, DPhil(Oxf) Director and Associate Professor, Department of Dermatology & Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital-Chiayi Assistant Professor, Chang Gung University, TaoYuan, Taiwan Editor, Cochrane Skin Group Best Poster Research Presentation Award, The ISPOR 5th Asia-Pacific Conference, 2012. Clinical Paper Publication Prize, La Roche-Posay AsiaPacific Foundation, 2010 and 2011 International Scholarship, 18th World Congress of Dermatology, Washington DC, US, 2004
Pin-Chi Chiu (邱品齊 ), M.D., MBA Chairman, Department of Dermatology, National Taiwan University Hospital Yun-Lin Branch Director, Taiwanese Dermatological Association Associate Reviewer, Journal of Cosmetic Dermatology Advisory Board Member, Cosmetic Regulation and Advertisement, Department of Health, Executive Yuan, R.O.C.(TAIWAN)
Chia-Yu Chu (朱家瑜 ), MD, PhD
Steven Feldman, MD, PhD
Assistant Professor, Department of Dermatology, National Taiwan University College of Medicine, Taipei Editor-in-Chief, Dermatologica Sinica Board of Directors, Taiwanese Dermatological Association (TDA) Board of Supervisors, Taiwanese Society for Investigative Dermatology (TSID) Excellent Teacher Award, National Taiwan University College of Medicine Ta-You Wu Memorial Award for Young Researchers, National Science Council, Taiwan
Professor, Department of Dermatology, Pathology, and Public Health Sciences, Wake Forest University School of Medicine Presidential Citation from the AAD in 2005 for his psoriasis education efforts Clarence S. Livingood Lecturership at the 2006 AAD Meeting Astellas Award in 2008 for research that improved public health in the field of dermatology. Editorial board: Journal of the American Academy of Dermatology, Journal of Dermatological Treatment, Journal of Cutaneous Medicine and Surgery.
John P. Cole, MD President, Cole Hair Transplant Group, Cole Instruments, Coleron Board of Directors and Examination Committee, American Board of Hair Restoration Surgery Recipient of two ISHRS Research Grands: Archimedes Award Michelangelo Award Diplomat of the American Board of Hair Restoration Surgery
Chee Leok Goh, MD, MBBS
Greg Goodman, MBBS (HONS) FACD
Senior Consultant Dermatologist and Medical Director (1990-2004), National Skin Centre Clinical Professor, National University of Singapore Adjunct Professor of the Duke-NUS Post Graduate Medical School Senior Consultant, Director of Medical Services Office, Ministry of Health, Singapore Member, Specialist Accreditation Board, Ministry of Health (2007~2010) Member, Specialist Training Committee for Dermatology in Singapore (1993~ ) Chairman, Taskforce for Aesthetic Medicine Workgroup, Ministry of Health (2007) Member, Singapore Medical Council Aesthetic Practice Oversight Committee and Subcommittee on Certificate of Competence Accreditation Chairman, Pharmacovigilance Advisory Committee of the Health Science Authority , Ministry of Health, Singapore Past President, Society of Laser Medicine and Surgery of Singapore Past President, Environmental and Occupational Dermatology Society of Singapore Past editorial board of the Contact Dermatitis (Munksgaard Publication) and past international editorial board member of the Archives of Dermatology and Journal of the American Academy of Dermatology. Public Administration Medal (Gold) in 2003
Greg Goodman, MBBS, FACD, MD, GradDipClinEpi, has been a practicing dermatologist for more than 20 years. His areas of specialty include skin cancers, Mohs micrographic surgery, lasers in dermatology, cosmetic dermatology, facial aging and the treatment of acne and acne scarring. He is an associate professor at Monash University in Melbourne, Australia. He is chief of surgery at the Skin and Cancer Foundation of Victoria. He is a national trainer for numerous temporary dermal fillers and is a member of several international editorial boards and advisory committees. He has always had a keen interest in skin care and skin therapeutics, and has published extensively on acne and acne scarring and the use of botulinum toxin, fillers, and lasers. His current research interest is skin aging. This interest has seen him develop the HOYS program. HOYS aim is to achieve long term effective outcomes via a systematic, integrated process of education, assessment and treatment planning. The HOYS system is currently available in Australia and New Zealand. Associate Professor Goodman has travelled the world to speak and lecture on a variety of dermatologic subjects including lectures in Australia, the United States, Singapore, New Zealand, Tokyo, Malaysia, the Philippines and Mexico. As part of these travels, he has been a guest lecturer for the International Society of Cosmetic Surgery, the World Congress of Dermatology, the American Academy of Dermatology, the Australasian College of Dermatology, the New Zealand Dermatological Society, and the International Academy of Cosmetic Dermatology. Associate Professor Goodmanâ€™s research has been published in such respected medical journals as the British Journal of Dermatology, Medical Journal of Australia, Australian Journal of Dermatology, Dermatological Surgery, and the American Journal of Clinical Dermatology.
Adelaide A. Hebert, MD
Ji-Chen Ho (何宜承 ), MD
Adelaide A. Hebert, MD, is a Professor in the departments of Dermatology and Pediatrics at the University of Texas–Houston Medical School. She is also Associate Professor in the Division of Craniofacial Growth and Development, Pediatric Dentistry, at the University of Texas–Houston Health Science Center Dental Branch.
Ever since the completion of my dermatological residency and fellowship training, I have worked as a dermatologist for Chang Gung Memorial Hospital in the past 20 years. Looking back at my past achievements in Taiwan, there are two major things which I am proud to have accomplished. First is the establishment of the first psoriasis day care center in Taiwan. This was built with the goal to provide quality and holistic care to patients diagnosed with moderate to severe psoriasis. Secondly, I pride myself to have trained more than twenty young, outstanding dermatologists. These talented young dermatologists have made major contributions to our society here and will in no doubt, continue to excel and succeed in the research and clinical areas of dermatological diseases. As an experienced dermatologist, I will continue to advance my education by learning new technologies, concepts and developments in the dermatology. Despite the thriving popularity of cosmetic dermatology, I plan to serve those in need by continuing my work in the field of diagnosing and treating traditional dermatological diseases as well as being a excellent physician educator.
Dr. Hebert’s clinical research experience is extensive, with studies on a number of dermatologic conditions including acne, eczema, psoriasis, and skin and skin structure infections. A prolific author, Dr. Hebert has written numerous journal articles, abstracts, book chapters, and letters to the editor. Her journal articles have been published in Archives of Dermatology, Journal of the American Academy of Dermatology, Dermatologic Therapy, Pediatric Dermatology, and British Journal of Dermatology, among others. She has served on the editorial boards of Pediatric Dermatology and Skin & Allergy News. Dr. Hebert has served on the boards of directors of the Women’s Dermatological Society and the Society for Pediatric Dermatology. She served as president of the Society for Pediatric Dermatology for the 2006 – 2007 term. She is a member of numerous professional societies, including American Medical Association, American Academy of Dermatology, Society for Pediatric Dermatology, and The American Dermatologic Association. She is a founding member of the International Hyperhidrosis Society, and has served on its Board of Directors from since 2001. She previously served as Vice-Chairman of the Department of Dermatology for nine years. Among the many awards and honors she has received are the Dean’s Excellence Award from the University of Texas Health Science Center and listings in The Best Doctors in America.
Po-Han Huang(黃柏翰 ), MD
Dalvi Humzah, B.Sc. (Hons), MB, BS(Hons), AKC, FRCS(Glas), FRCS(Eng), FRCS (Plast), MBA
Dr. Huang is a recognized expert on psoriasis and aesthetics, and he conducts several clinical trials. He set up the first Psoriasis Treatment Center in Taiwan before he was appointed as the Chair of Department of Dermatology, Chang Gung Memorial HospitalKaohsiung in 2002. He has been invited to speak at national and international meetings (including the Asia Congress of Dermatology and Hong Kong Association of Specialists in Dermatology). He serves a reviewer for Journal of Cosmetic Dermatology and International Journal of Dermatology. In 2009, Dr. Huang was voted as "Good Doctor in Taiwan" in Business Weekly.
Medical Director, Plastic and Dermatological Surgery, Midlands, UK Consultant Plastic Reconstructive & Aesthetic Surgeon in the NHS Honorary Consultant Plastic Surgeon, Queen Victoria Hospital, East Grinstead STEP® Tutor for the Royal College of Surgeons of England Examiner, the Intercollegiate MRCS for the Royal College of Surgeons of Glasgow Regional Advisor, the Royal College of Physicians and Surgeons of Glasgow Sub-Editor, Cyber Medical College. Royal College of Physicians and Surgeons of Glasgow Reviewer, British Journal of Plastic Surgery, Medical Science Monitor, Clinical Evidence – BMJ Group
Executive Director, Board of Trustees, and Vice Chair, Committee for Aesthetic Dermatology, Taiwanese Dermatological Association Member, Committee for Dermatologist Qualification and Board Examination in Taiwan Member, Committee for Accreditation of Dermatology Residency Training Institute in Taiwan Director, Huang PH Dermatology and Aesthetics, Kaohsiung Chair, Department of Dermatology, 2002~2004, and Outstanding Educator Award in 2005, Chang Gung Memorial Hospital-Kaohsiung
Peter Huang (黃耀主 ), MD 學歷 1989 中國醫學大學醫學系畢業 1989 國泰醫院外科住院醫師 1992 國泰醫院整形外科住院醫師 1994 美國哥倫比亞大學頭頸部外科研究員 2001 美國功能醫學學院研究員 2002 美國史丹弗大學商學院企業管理碩士班學員 2003 台灣大學管理碩士學分班學員 經歷 國泰醫院整形外科醫師 台北醫學大學整形外科 兼任主治醫師,講師 燒傷醫學會 理事 敏盛醫院整形外科 主任 敏盛醫院 Elsye 整形美容醫學中心 醫務執行長 現任 瑞倍佳美容醫學中心 院長 95
Yu-Huei Huang(黃毓惠 ), MD
Tae-Heung Kim, MD, PhD
Assistant professor, Chang Gung Memorial Hospital Attending Physician, Chang Gung Memorial Hospital, Taipei International fellowship, Department. of Dermatology, Toranomon Hospital, Tokyo Research fellow, Department of Tissue Engineering, International Medical Center, Japan
Po-Han Huang, MD is the Director of Huang PH Dermatology and Aesthetics in Kaohsiung, Taiwan, and serves as an Executive Director of Board of Trustees and the Vice-Chair of Commi Directorin-Chief, White-Line Skin Clinic, Changwon, Kyungnam, Korea (2003~ ) Instructor, Assistant Professor, Associate Professor, Professor and Chairman, Department of Dermatology, College of Medicine, Gyeongsang National University (1991~2003) Postdoctoral fellowship on photoimmunology & photocarcinogenesis funded by the R.E. Bob Smith Research Foundation (1996~1998) Council Member, Korean Society of Photomedicine Secretary, Korean Society of Photoscience Vice President, Korean Society for Vitiligo Secretary, Cosmetic Treatment, Practitioners' Association, The Korean Association of Dermatologists (2005~2007) Publication: 109 publications(74 domestic and 35 international: 27 SCI and SCIE)
Genji Imokawa, Ph.D Visiting Professor, Research Institute for Biological Functions, Chubu University, Aichi, Japan Professor, School of Bioscience and Biotechnology, Tokyo University of Technology The Society of Cosmetic Chemists, The Joseph P. Ciaudelli Award as the Best Article on Hair Care Technology (2006) Board of Directors: Japanese Pigment Cell Society, Japanese Society for Ceramide Research Councilors: Japanese Society for Investigative Dermatology, Japanese Cosmetic Science Society, Japanese Photo-Aging Society, Japanese Anti-Aging Medical Society, Japanese Skin Aging Society. More than150 English papers with more than 500 of cumulative impact factor.
Cheng-Che Eric Lan(藍政哲 ), MD, PhD Associate Professor, Department of Dermatology, Kaohsiung Medical University Chair, Department of Dermatology, Municipal TaTung Hospital, Kaohsiung
Chih-Hung Lee (李志宏 ), MD, PhD
Mao-Qiang Man, MD
Associate Professor, Department of Dermatology, Kaohsiung Medical University, Kaohsiung Chair, Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Executive Director, Taiwan Society of Investigative Dermatology Invited Chair, Psoriasis 2013 Congress of Psoriasis International Network, Paris, France
Assistant Research Biologist, Dermatology, University of California San Francisco, CA Research Scientist, Dermatology, Northern California Institute for Research and Education, San Francisco, CA, USA Visiting professor, China Medical University, Liaoning, China Pan Asia-Pacific Barrier Research Society, Director board member (2009~2010) and Advisory board member (2011~ ) Editorial Board, Chinese Journal of Dermatovenereology and Clinical Journal of Dermatology.
Tzu-Kai Lin (林子凱 ), MD Attending Physician, Department of Dermatology, National Cheng Kung University Hospital, Tainan Director, Department of Dermatology, Buddhist TzuChi General Hospital-Dalin Branch Ronald Moy, MD 2003, President of the American Society for Dermatologic Surgery 2005, Appointed to Professor at UCLA (the highest academic rank) 2005, American Academy of Dermatology "Presidential Citation" Award 2005, American Academy of Dermatology Leadership Circle for Volunteerism 2006, President of the Pacific Dermatologic Association 2006, President, Division of Medical Quality, Medical Board of California 2011, President, the American Academy of Dermatology
Han-Nan Liu (劉漢南 ), MD Head, Department of Dermatology, Veterans General Hospital-Taipei Adjunct Associate Professor, Department of Dermatology, National Defense Medical Center, Taipei American Board-certified Dermatologist (1986) American Board-certified Dermatopathologist (1987)
Nark-Kyoung Rho, MD
Jerry Shapiro, MD
Medical Director, Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul, Korea Clinical Associate Professor, School of Medicine, Sungkyunkwan University, Seoul, Korea Excellence Speaker Award (2nd International Congress of Minimal Invasive Plastic Surgery and Dermatology, Seoul, Korea) Director of Education, Korean Academy of Botulinum Toxin Therapy Board-certified dermatologist and dermatologic surgeon in Korea, currently practicing in a network clinic Academic speaker on cutaneous surgery and cosmetic surgery Author and reviewer of scientific articles in the field of dermatology Currently, practice devoted almost exclusively to cosmetic dermatologic surgery, light/laser/RF/ ultrasound-based technologies, treatment of acne, and the anti-aging procedures including botulinum toxin , fillers, and fat grafting. Research interest: Injectable fillers, Botulinum toxin injection, soft tissue augmentation, treatment of hyperhidrosis and osmidrosis, liposuction, non- or minimally ablative skin rejuvenation procedures, laser/ light/RF/photodynamic therapy of acne vulgaris.
Clinical Professor, Department of Dermatology, New York University and University of British Columbia Director, the Hair Transplant Center Vancouver, University of British Columbia. Past President, the North American Hair Research Society and the Academy of Dermatology and the Royal College of Physicians and Surgeons of Canada. The first dermatologist in the world to exclusively restrict his practice to both medical hair and scalp disorders as well as hair transplant surgery
Sam-Shik Shin, MD Chief doctor, Malgeun Dermatology Clinic Adjunct Professor, Department of Dermatology, Cheonnam National University Medical School Adjunct Professor, Gwangju Health University Director, Korea Dermotoxin Institute
International Master Course on Aging Skin (IMCAS) Paris and Asia Scientific Committees, the ISDS Board of Directors, and as President of the FACE2FACE 2013 Congress in Cannes. She is a Principal Investigator for FDA studies of new aesthetic technologies and a Chair and Course Director of physician education initiatives. She lectures internationally at dermatology and plastic surgery conferences and is an advisor to Medscape, the Dermatology Education Initiative, The HealthCentral Network online and Fitness magazine.
Hema Sundaram, MD Associate Editor, Journal of Drugs in Dermatology Course Director, American Society for Dermatologic Surgery (ASDS) Art and Science of Injectables Course, Boston Education Work Group, and Mentor of Future Leaders Network, ASDS International Council, International Society for Dermatologic Surgery (ISDS) Course Director and Editor, The New Face of Fillers: An Evidence-Based Multi-Specialty CME Initiative, Journal of Drugs in Dermatology
Dr. Sundaram is an Associate Editor for the Journal of Drugs in Dermatology, an Editorial Advisor to other journals including Prime, and the author of a book, Face Value [Rodale], which was honored by the National Press Club. Her medical publications include chapters on fillers, toxins, lasers and cosmeceuticals, and she is the Dermatology Editor for the 2nd Multidisciplinary Edition of Clinics in Plastic Surgery. Her clinic is noted for its charitable donations.
Dermatology, Cosmetic and Laser Surgery of Rockville and Fairfax Addresses: White Flint Professional Building, 11119 Rockville Pike, Ste 205, Rockville, MD 20852 Yorktown 50 Building, 8316 Arlington Blvd, Ste 401, Fairfax, VA 22031 E-mail: email@example.com Hema Sundaram, MD FAAD, is a fellowship-trained, board certified dermatologist, and the Founder and Medical Director of her aesthetic dermatology practice in the suburbs of Washington, D.C. in the United States. She holds masters and medical degrees with honors from the University of Cambridge in England. Her subsequent training includes a pre-registration year at The Royal London Hospital, dermatology residency at the University of Chicago, post-doctoral research in molecular biology, and a medical staff research fellowship at the National Institutes of Health during which she served as a Lieutenant Commander in the U.S. Public Health Service.
Tsen-Fang Tsai, MD Associate Professor, Department of Dermatology, National Taiwan University Hospital Board of Taiwanese Dermatological Association Former Editor-In-Chief, Dermatologica Sinica Clinical researcher, Jefferson Univeristy, USA Research associate, Universityof California, San Francisco (UCSF)
Dr. Sundaram is a Fellow of the American Academy of Dermatology (AAD), the American Society for Dermatologic Surgery (ASDS) and the International Society for Dermatologic Surgery (ISDS). She has received awards for her clinical and research work. Dr. Sundaram feels fortunate to maintain an active involvement in medical research and education, serving on the ASDS Education Work Group, the
Jiu-Yao Wang (王志堯 ), MD, Dphil.(Oxon)
Li-Fang Wang (王莉芳 ), MD, PhD
Distinguished Professor of Pediatrics and Director, Division of Allergy, Immunology and Rheumatology, College of Medicine, National Cheng-Kung University, Tainan President, Taiwan Academy of Pediatric Allergy, Asthma and Clinical Immunology Congress Chair, Asia Pacific Congress of Allergy, Asthma and Clinical Immunology (APCAACI), 2013
Associate Professor, Department of Dermatology, National Taiwan University Ph.D. Institute of Microbiology, National Taiwan University Visiting fellow, Dermatology Branch, National Cancer Institute, National Institute of Health, USA.
Kyu-Kwang Whang,MD, PhD Kuo-Hsien Wang(王國憲 )
CEO, Serion Dermatologic & Aesthetic Surgery Center Congress President& Chair of Organizing Committee, 36th International Society for Dermatologic Surgery, Seoul, 2015 Board Member of Korean Society of Invesgative Dermatology Secretary General (Founding) of Korean Society for Dermatologic Surgery International Fellow of International Society for for Dermatologic Surgery Assistant editor, Annals of Dermatology Consultant in Dermatology & Dermatologic Surgery, 121 US Army Hospital in Yongsan, Seoul, Korea Chair, Korean Society for Aesthetic and Dermatologic Surgery Dong-A Academic Co-Awardee (Korean Dermatologic Association, KDA) Hyundai Academic Co-Awardee (KDA), Awardee (KDA,2000) 1993 Perry Robins Scholarship Awardee (ISDS) KDAA Scholarship Awardee MSD academic Awardee
Chief, Department of Dermatology, Taipei Medical University Hospital Assistant Professor, College of Medicine, Taipei Medical University Master of Science, Graduate Institute of Medical Sciences, Taipei Medical University Visiting Postdoctoral Fellowship, Section of Dermatopathology, University of California, San Francisco (UCSF) Visiting Scholar, Department of Pathology, Stanford University
Wenyu Wu, MD, PhD
姚教授為國內外著名的民法學者, 其學識淵博、著作等身、尊師 重道、謙虛勤勉。今日教授早已望重法界與杏壇，仍然始終如 一。誠如教授於其侵權行為法一書序言所云，教授師承民法泰斗
Vice Chairman, China Dermatologist Association, Dermsurgery Group Board Member, China Dermatological Society of Integrated Traditional and Western Medicine, Dermsurgery Group Board Member, Shanghai Dermatological Society Board Member, Shanghai Medical Aesthetics and Plastic Societ
邱聰智教授、茁壯於Goettingen大學、後受林秀雄教授啟發， 並受郭振恭教授讚賞推薦。多年來教授一直感恩在心，時常提 起。教授除了於民法學，尤其是民法債篇有深入研究與超凡見解 外；其實，教授對於商事法、公司法、比較法學亦功力深厚，並 廣受產、官、學界推崇，此於教授豐富之經歷，可略窺一二。 學歷:德國哥廷根大學(Göttingen 經歷:國立高雄大學法學院院長 法律學系系主任 財經法律學系系主任
EMLBA執行長 現任:輔仁大學法律系專任教授 中華民國工程法律學會理事長 考試院法規會委員
Brian Zelickson, MD President, American Society for Laser Medicine and Surgery, 2011 Clinical Associate Professor, Department of Dermatology, University of Minnesota Medical School's and director of its Electron Microscopy Laboratory Dr Zelickson participates in resident teaching and as a training site for the Procedural Dermatology Fellowship. Over 50 articles and several book chapters and somewhere along the line became interested in lasers.
朱俊穎律師 朱律師為新銳律師界的年輕才俊，畢業不久即取得法學碩士學 位與律師執照。故相當年輕即有豐富的辦案經歷。朱律師的專 長有法律諮詢、契約審閱、法律意見書、契約見證 民商事案 件、家事案件、刑事案件、強制執行案件與各類法律文件撰 寫。朱律師熱心公益，本身也是財團法人崔媽媽基金會法律義 工，樂於接受各種法律疑難雜症的挑戰。其個人的電子信箱為
firstname.lastname@example.org。 學歷:台北大學法律系法學碩士 律師高考及格 土地登記專業代理人(地政士)考試及格 智慧財產培訓學院-專利工程師基礎班結業 經歷:司法院「司法智識庫強制汽車責任保險法整編專案」研究員 最高法院刑事庭法官助理 高雄高等行政法院法官助理 現職:德宇國際法律事務所律師 財團法人崔媽媽基金會法律義工 台北市信義區公所法律諮詢律師 新竹市政府消費爭議調解委員會委員
李律師畢業於中原大學，在學時即為學業上的標竿，是系上風雲 人物。李律師沉穩、不疾不徐，縱使面對過度嚴格的學業挑戰， 不但從容不迫而且依然出色。李律師成績優異，於大學部畢業後 直升碩士，於畢業前即已取得律師執照，更屬難得。李律師專精 於民刑事案件、侵權行為案件與智慧財產權案件。其電子信箱
周醫師為成功且出色的醫師。周醫師除於醫學、皮膚外科學有專 精之外，對於經濟理論、風險管理學、法律學與生物科技管理也 有很深的造詣。周醫師自學法律，其法學功力，勝過科班同學。 於住院醫師時期，即通過法律類科國家檢定考試，同年並高分錄 取民間公證人全國榜首。周醫師亦於住院醫師階段錄取台北大學 法研所，後因醫務繁忙，且錄取教育部公費留學考試，赴美國
為: email@example.com。 學歷:中原大學財經法律研究所 律師高考及格 經歷:彰化地方法院檢察署書記官 劍無鋒法律事務所實習律師 法律諮詢律師 現任: 銘法法律事務所律師
University of California, San Diego取得生物科技與管理 碩士。想多知道這位傳奇醫師嗎?請以Dr. Stanley為關鍵詞搜尋 就知道啦! 現職:芯悅皮膚科診所執行長 中國醫藥大學台北分院皮膚科主治醫師 台灣生醫電子工程協會皮膚科召集人 合盈醫電控股醫療長 學經歷:台北醫學大學醫學士 美國加州大學聖地牙哥分校管理碩士 美國加州大學聖地牙哥分校皮膚科與皮膚外科研究 教育部公費留考生物科技管理學門及格 高等檢定考試法務類及格 民間公證人國家考試榜首 台北長庚醫院皮膚科主治醫師 嘉義長庚醫院皮膚科主任 著作:(僅錄中文部分)
醫師，救救我的皮膚(華成出版，2012) 醫學美容 (華杏出版，2011)
王院長為出色的資深皮膚科醫師，畢業於高雄醫學院，為高雄醫 學院與美國哈佛大學雙碩士。院長診療病患親切仔細，於南臺灣 極富盛名。院長也熱心公益，除當選多屆的皮膚科醫學會理事之 外，也擔任醫師公會醫療問題處理小組委員。院長才行均佳，並 樂於分享，不只教導年輕後輩醫師，更常受其他醫學會之邀，講
滾開!體脂肪 (華成出版，2010) 皮膚保養，你做對了嗎？(華成出版，2010) 打造外在美－認識皮膚美容外科 (華成出版，2009)
述與分享醫療經驗。 2012 年更擔任皮膚科醫學會春季會與第一 屆皮膚美容醫學會主辦小組成員，其熱血精神，足堪年輕醫師表 率。 學歷:高雄醫學院醫學士 高雄醫學院醫學研究所醫學碩士 美國哈佛大學公共衛生學院職業衛生碩士 經歷:高雄市立大同醫院皮膚科主任 高雄醫學院皮膚科學兼任講師 美國加州大學舊金山醫學院皮膚科研究員 台灣皮膚科醫學會理事(第13 、14、15、16、18屆) 台灣皮膚科醫學會常務理事(17屆) 高雄市醫師公會第十、十一屆醫療問題處理及互助辦法研 究委員會委員 王銘燦皮膚科診所院長
許修誠醫師 許醫師畢業後分發國軍台中總醫院服役，其間於東海大學法律系 夜間部就學，大三時退伍離開東海大學，同年取得小兒科專科醫 師，並依公職醫師高考三級，分發署立南投醫院任主治醫師。後 於台北長庚皮膚科訓練，並開始於中原大學財經法律研究所求 學，後獲楊志勛主任、施一新主任鼓勵，考取教育部獎學金補助 赴美進修，獲 University of California, Davis 法學碩士， 並於該校附設醫院進修、回國後取得中原大學財經法律研究所碩 士。與李柏松律師為研究所同窗。 現職:彰化基督教醫院皮膚部皮膚外科主治醫師 學經歷:中原大學財經法律研究所碩士 美國加州大學戴維斯校區法學碩士 美國加州大學戴維斯校區 中國醫藥大學醫學士 教育部公費留學獎學金 台北長庚醫院皮膚科主治醫師 衛生署南投醫院小兒科主治醫師
100 95 75
25 5 0
1 2 3
下表為Yelomod在光譜測試儀的光譜檢測報告 單位：40W/m 2
微創 光 療 肌 膚 修 護 品 牌
微創光療即刻修護 D-NA 肌因修護敷膜 D-NA Repair Dressing
D-NA 肌因修護精華露 D-NA Repair Gel
D-NA 肌因修護防曬霜 D-NA Sun Repair Cream
3D 玻尿酸精華液 HAS Serum
1. 獨家受損肌膚專利修護抗老因子Sacchachitin ® (Patent No. 137433) 2. 100%堅持無添加防腐劑、香精、酒精、色素。 3. PIC/S GMP國際藥廠安全規格監製&研發。