Clinics in Dermatology (2014) 32, 331–334

CONGRESS REPORTEdited by Marcia Ramos-e-Silva, MD, PhD

Ninth World Congress of the International Academy ofCosmetic Dermatology, Athens, Greece, June 27-30, 2013Vesna Petronic-Rosic, MD, MSc⁎

Section onDermatology, University of Chicago Pritzker School of Medicine, 5841 SMaryland Ave, MC 5067, Chicago, IL 60637

The Ninth World Congress of the International Academyof Cosmetic Dermatology (IACD) was held in Athens,Greece, from June 27-30, 2013 under the joint presidency ofChristina Antoniou and Andreas Katsambas, Athens, Greece(Figure 1). The International Academy of CosmeticDermatology (IACD), Hellenic Society of Dermatologyand Venereology (HSDV), and the University of AthensMedical School skillfully organized the Congress (Figure 2).This extraordinary venue in the cradle ofWestern civilizationand the birthplace of democracy helped to make theCongress a great success.

Highlights: An overview

A rich and colorful academic program was led by some ofthe most authoritative names in the many areas of cosmeticdermatology. Speakers came from all corners of the globe(Figure 3).

The Eugene Van Scott Lecture, named in honor of Dr.Van Scott's many contributions to dermatology and tocosmetic dermatology, in particular, was delivered byWilliam P. Coleman (New Orleans, LA) who opined onwhere we are with invasive and noninvasive body contour-ing. He stressed that liposuction remains the gold standardfor body contouring, but there are many new devicesavailable to the cosmetic dermatologist.

⁎ Corresponding author.E-mail address: vrosic@medicine.bsd.uchicago.edu (V. Petronic-Rosic).

0738-081X/$ – see front matterhttp://dx.doi.org/10.1016/j.clindermatol.2013.11.014

Marina Papoutsaki, Athens, Greece, introduced us towhat is new in psoriasis with special emphasis on howperceptions are slowly changing from that of a purely skinmanifestation to a complex, systemic disease. This has led tothe development of new, advanced treatments, givingdermatologists an enhanced armamentarium to counter thedisease, which is, in turn, leading to increasingly efficaciouspatient outcomes.

Two excellent case reports won this year's Edward L.Keyes Award for the best Resident Papers, established in2012 in memory of Dr. Keyes, a New York dermatologist,who might be considered the first cosmetic dermatologist forhaving developed the cutaneous punch, better known as theKeyes punch. The winners of the contest, Dominique CPichard, MD, Washington, DC, and Navid Ezra, MD,Indianapolis, IN, presented their case reports: (1) zincdeficiency disorders among extremely premature infants,and (2) localized scleroderma treated with ablative fractionallaser therapy and injectable fillers, respectively (Figure 4).

Many interesting and novel observations were sharedthroughout the scientific sessions and the poster presenta-tions. Experts from around the world offered pearls fordiagnosis and treatment of both common and rare skinconditions. A faculty of 124 participants offered theirexpertise to 831 delegates through 13 workshops, 18sessions, 3 satellite symposia, 6 free communicationssessions (45 abstracts), 4 sponsored lectures, and 1 specialsession. There were also 55 posters and 55 exhibitors. A trueworldly mix of attendees from 71 countries, included visitorsfrom Argentina, Japan, New Zealand, Luxembourg, Singa-pore, Yemen, and China, to name a few.

Fig. 1 Lawrence Charles Parish and Andreas Katsambas. Fig. 3 Torlief Roykenes, Marcia Ramos-e-Silva, Larry E.Millikan, Francisco Perez Atamoros, and Lawrence Charles Parish.

332 V. Petronic-Rosic

The nearby Andreas Syggros Hospital Museum extendedits weekend hours to accommodate viewing of theirimpressive collection of wax models, the first of its kind,created by the Hospital Director and Professor of Dermatol-ogy, G.O. Foteinos starting in 1912.

The program in review

The special session, entitled “Tulane” (as in everyonepresenting was affiliated with Tulane University), was chairedby Larry E. Millikan, Meridian, MS (Figure 5). It was filledwith a potpourri of remarkable individuals discussing a varietyof issues in contemporary dermatology. Lisa Donofrio, NewHaven, CT, spoke about what's new in lipofilling and pointedout that the fat is replete with stem cells, which have greatpotential for regenerative medicine. William Coleman, NewOrleans, LA, Editor-in-Chief of Dermatologic Surgery,presented results from some of the most interesting submittedpapers in the past year. Lawrence Charles Parish, Philadelphia,PA, gave a historical and heartfelt presentation on thepathfinder for American dermatology Louis A. Duhring(1845-1913) on the centennial of his death. Jennifer L. Parish,Philadelphia, PA, discussed the potential for complicationsinherent to the so-called “lunch-time” cosmetic proceduresand how to handle both the “oops” and the patient in suchsituations. In his presentation on the aging face: Optimalmedical-surgical aspects, Larry E. Millikan recommended thecorrect combination of retinoids, implants, and neuroblockersto achieve the desired goal.

Fig. 2 The Conf

In the session on lasers, Konstantinos Neamonitos,Athens, Greece, stated that full resurfacing with CO2 andErbium-Yag lasers undoubtedly gives better results in scars,wrinkles, and photodamaged aged skin than fractionalresurfacing but does cause more complications, such asedema, erythema, and hyperpigmentation that may takemonths to resolve. Christoforos Tzermias, Athens, Greece,spoke about the shift to nonablative techniques, also knownas dermal remodeling, subsurface resurfacing, or lasertoning, as the new focus.

Mohamed Amer, Cairo, Egypt, discussed melasma and itsrelationship to hormonal levels and sun exposure. TaniaCestari, Rio Grande do Sul, Brazil, acquainted us with theparticulars of extrafacial melasma, and Chee-Leok Goh,Singapore, Singapore, commented how melasma shouldbe managed as a chronic relapsing disorder akin to psoriasiswhere induction and maintenance phases of treatmentare necessary.

Sibel Alper, Istanbul, Turkey, gave an in-depth presen-tation about the treatment of vitiligo, underscoring thatthe face and trunk lesions respond better than otherareas, while hands, feet, perioral, and periorbital lesionsare refractory to treatment. Torello Lotti, Rome, Italy,introduced new treatments for vitiligo, such as microphototherapy with narrowband UVB Excimer laser and mono-chromatic Excimer light.

Marcia Ramos-e-Silva, Rio de Janeiro, Brazil, spoke onthe importance of photoprotection for skin of various coloredpatients. Dusan Skiljevic, Beograd, Serbia, presented the

erence Logo.

Fig. 4 Navid Ezra, Vesna Petronic-Rosic, and Dominique C.Pichard.

ig. 6 Diane Benedetto, Anthony Benedetto, Kerry Coleman,illiam P. Coleman, III, Larry E. Millikan, and Paula Karam.

3339th IACD Congress Report

results of a study on UV exposure and UV protectionbehaviors among adolescents: Current problems and ourexperience, which concluded that UV protection behaviorsamong adolescents were inadequate.

Controversies over proper dilution and dosing ofbotulinum toxin still remain for treatment of facialmusculature. Argyri Kaperllari, Athens, Greece, addressedhow to individualize treatment by placing higher concentra-tions more accurately in the periorbital and perioral areas.Higher dilutions provide a less steep gradient between theinjection areas, greater spread, weaker paralysis, and shorterduration of results. Andreas Katsambas, Athens, Greece,talked about the 20% of patients who have expresseddissatisfaction with the final outcome of botulinum toxintreatment. Some of the reasons for unhappiness includeinadequate dosing, lack of consultation, and poor injectiontechniques. Jaishree Sharad, Mumbai, India, pointed outhow to avoid complications and obtain excellent resultsin patients.

Eckart Haneke, Freiburg, Germany, instructed on theproper techniques for performing aesthetic nail surgery.Anthony Benedetto, Philadelphia, discussed his personal

Fig. 5 William P. Coleman, III, Constantine B. Noutsis, Larry E.Millikan, and Jennifer L. Parish.

FW

approach to dermal fillers, while Christos Naoum, Athens,Greece, showed us how dermal fillers may be an affordable,noninvasive, and safe method to treat aging hands and how itis a procedure that requires little down time and nopreparation. The ideal dermal filler must be compatiblewith our bodies, hypoallergenic, nonirritating, and nontoxic.Ines Verner, Tel Aviv, Israel, talked on the topic of liprejuvenation, which is commonly performed, but naturallooking lips are still a great challenge. She underscored theimportance of understanding lip anatomy, the desired lipstructure, and its possible deviations.

Nikolaos Kalogeropoulos, Pireus, Greece, introduced usto platelet rich plasma for mesotherapy as safe and effectivein promoting the natural processes of wound healing, softtissue reconstruction, hair follicle growth, bone reconstruc-tion, and soft tissue augmentation. George Kroumpouzos,Providence, RI, discussed the management of pregnancyrelated striae, keloids, hypertrophic scars, and excessiveskin laxity. Venkataram Mysore, Bangalore, India, presentedhis recommendation for the use of lasers in brown skinand the results of a study with 158 patients showing that

Fig. 7 Maria Tsoukas and Vesna Petronic-Rosic.

334 V. Petronic-Rosic

various procedures may be done safely while patientsare on isotretinoin.

Lawrence Charles Parish, Philadelphia, PA, chaired asession on Aging in a Cosmetic World, where he definedaging as a maturing process (I like that!). Maria Tsoukas,Chicago, IL, explained the pathophysiology of aging, plusthe intrinsic and extrinsic pathways, including chronologicaging and molecular alterations induced by UVR exposure,respectively. Riccarda Serri, Milan, Italy, talked about theeffects of pollutants in the air, while W. Clark Lambert,Newark, NJ, explained how a rare inherited disease,xeroderma pigmentosum, disables cells to cope withchemical changes induced in DNA by UV radiation.Vesna Petronic-Rosic, Chicago, IL, explained that agingskin is at greater risk of injury, disturbance in sensation,heat intolerance, and increased number of growths, bothbenign and malignant. She stressed the impact ofdeleterious extrinsic factors, such as intense physical andpsychological stress, alcohol intake, poor nutrition, over-eating, environmental pollution, and UV exposure. NikolaiTsankov and Jana Kazandzijeva, Sofia, Bulgaria, gave anenchanting presentation on balneology and aging andpointed out the effects mineral water may have on skin andhow this was depicted throughout known history.

An always-popular session on Complications in Cosmeticand Dermatological Surgery included discussion of sideeffects from various cosmetic procedures (Jana Kazandzi-jeva, Sofia, Bulgaria), dermal fillers (P. André, Paris,France), botulin toxins (Jennifer L. Parish, Philadelphia),and treatment of acne fulminans (Hana Zelenkova, Svidnik,Slovakia). Vesna Petronic-Rosic, Chicago, IL, gave an indepth presentation on compromised skin conditions, empha-sizing common myths and effective methods for overcomingskin sensitivity.

Anthony Benedetto, Philadelphia, PA, instructed thedelegates on techniques he uses to treat facial asymmetrywith Botulinum toxin A, while Oliver Kreyden, Zurich,Switzerland, spoke on the aesthetic needs of men, stressingthat men do not accept side effects or pain as easily as womendo. Only some men are willing to undergo treatment in thelate stage of the aging process with deep wrinkles, oftennecessitating a combination of procedures for optimalresults. Ercan Arca, Ankara, Turkey, reviewed the compli-cations of chemical peelings, while Georgios Kontochristo-poulos, Athens, Greece, reviewed methods for choosing theright peel for the right patient.

In a session devoted to acne and rosacea, MirjanaMilinkovic, Beograd, Serbia, talked on the topic of adultfemale acne and the reasons it is a different disease subgroupfrom adolescent acne. Maja Zivkovic, Zagreb, Croatia,discussed the quality of life in patients with acne andthe positive influence of corrective cosmetics and camou-flage therapy.

The final session explored photodynamic therapy forcosmetic indications (Marita Kosmadaki, Athens, Greece),treatment of high-risk facial basal cell carcinoma(Carmen Salavastru, Bucharest, Romania) and variousexpected medical and aesthetic outcomes (Maria Tsoukas,Chicago, IL). Leonardo Marini, Trieste, Italy, introducedthe method of thermo-fractional PDT for nonmelanomaskin cancer.

Social events

In addition to the unique, interesting, and innovativepresentations that kept the audience stimulated throughoutthe Congress, the social events were commendable. Theregistrants can hardly forget the evening visit to theParthenon. After a spirited guided visit to the AcropolisNew Museum, a delicious dinner was hosted by thePresidents of the Congress, Andreas Katsambas andChristina Antoniou, at the Restaurant “Dionysos Zonars,”just opposite the magnificently lit Acropolis ArchaeologicalSite. The farewell dinner was held poolside at the lovelyAthens Hilton now celebrating its fiftieth anniversary(Figure 6). Many of the participants extended their stay bya few days and enjoyed visiting Daphne and Olympus or theenchantingly beautiful Greek Islands (Figure 7).

Conclusions

Athens is a fabulous city to visit, and the weathercooperated, allowing for many of the participants to enjoy arepast by the pool of the conference hotel or to visit the manyhistoric sites within easy reach. The hospitality and warmthof our hosts were truly commendable and made us all feelvery welcome and indeed most important.

We look forward to the 10th World Congress of the IACDin Rio de Janeiro, Brazil, July 18-20, 2014.