Prof. Dr. Darlenski Razvigor

Prof. Dr. Darlenski Razvigor

Prof. Dr. Darlenski Razvigor

Prof. Dr. Razvigor Darlenski
Acibadem Cityclinic Tokuda Hospital Sofia Bulgaria

Aesthetic psychodermatology
Autor: Razvigor Darlenski

Psychodermatology, an emerging interdisciplinary field at the intersection of dermatology and psychiatry, offers profound insights into the complex relationship between the mind and skin. In aesthetic practice, where patient expectations and self-perception play pivotal roles, psychodermatology provides essential tools to enhance both clinical outcomes and patient satisfaction. This lecture explores the psychological underpinnings of common aesthetic concerns, such as acne, rosacea, aging skin, and body dysmorphic disorder, emphasizing the impact of emotional stress, anxiety, and self-image on skin health and treatment response. By integrating psychodermatologic principles, aesthetic practitioners can better identify underlying psychosocial factors that may influence treatment efficacy, improve patient communication, and tailor interventions that address both physical and psychological needs. The discussion highlights strategies for incorporating psychological screening tools, managing high-risk patients, and collaborating with mental health professionals to optimize care. Special attention will be given to the ethical considerations of treating patients with unrealistic expectations and the importance of fostering a holistic, empathetic approach in aesthetic medicine. This lecture aims to equip practitioners with practical knowledge to recognize psychodermatologic conditions, improve therapeutic alliances, and ultimately deliver safer, more effective, and psychologically informed aesthetic care.

Scurt CV

Razvigor Darlenski is a dermatologist coming from Bulgaria. In 2014 he was selected as an associate professor at Trakia University, Stara Zagora. In 2010 he has defended a PhD thesis on the role of epidermal barrier for skin irritation and sensitization. Currently he is working as dermatologist at Tokuda Hospital Sofia, Bulgaria. Dr. Darlenski has published more than 70 papers in peer-reviewed journal and he is also an author of 12 book chapters. Dr. Darlenski is a member of the following organizations: Bulgarian Dermatological Society (BDS), member of the Honours & Awards committee of the European Academy of Dermatology and Venereology, Junior working group of the World Allergy Organization, European Academy of Allergology and Clinical Immunology, European Epidermal Barrier Research Network, European Network for Cutaneous Adverse Effects of Drugs (ENCAD), European Surveillance System on Contact Allergies, Union of Scientist in Bulgaria, Bulgarian Allergology Society, Bulgarian Medical Association, National Bulgarian Society of Aesthetic Surgery and Aesthetic Medicine, International society of skin physiology and pharmacology (ISP).
He is a winner of several awards among which Inaugural Edward L. Keyes award of the IACD for this meeting in Cancun (2012), Winner of the EER fellow award of the ESDR and ASDV (2013), Michael Hornsetin Memorial Scholarship of the EADV (2009).
His research interests are focused on skin barrier, drug reactions of the skin, skin irritation, contact allergy, urticaria, atopic eczema, and non-invasive methods in dermatology.

Contactează operatorul PDI 2025

4 + 5 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro

Prof. Dr. Heim Dominik

Prof. Dr. Heim Dominik

Prof. Dr. Heim Dominik

Prof.Dr. Heim Dominik
General surgeon and venous specialist at the Venenzentrum in Thun, Switzerland, and the president of the EVF in 2019–2020

Innovations in the treatment of varicose veins

Author: Dominik Heim

No fundamental innovations have emerged in the last few years (apart from HIFU, but to early to commercialise in a large scale), but modifications for the known treatments are reported. The followint items will de demonstrated and explained:
– tumescence through the vein wall (solutio catheter)
– better foam quality (varixio)
– diagnostic asessement of non-/ less visible varicose veins (thermography, near infrared (NIR)-Light)
– Increasing venous return in venous ulcers (Geko)
These modifications might make life easier for those dealing with varicose veins.

Skin transplants – easy made

Author: Dominik Heim

After excision of skin disorders (tumor, traumatic defect and other etiology) a skin-defect quite often remains. An option to cover those areas are local skin flaps or even vascularised musculo-cutaneous flaps.
Less invasive are free skin transplants in local anaesthesia: mesh-grafts, thiersch and full thickness transplants. Often these procedures can be done in local anaesthesia and in a out-patient setting. This is especially important for older, frail patients.
Full thickness : the advantage is less shrinking (e. g on the face), the donor site can be at the neck
Thiersch: suitable for larger defects, donor site thigh or lateral side of the shoulder.
Mesh graft: the advantge is its ability to cover large defect. By meshing the graft can be stretched. Donor site at the same localisation as the Thiersch.
The postoperative treatment is he same for all modalities: Compression, first change of dressing after 5-7 days, honey dressing for the donor site.

Scurt CV

Born in Zürich, Switzerland, 28th August 1949

Graduated at the University of Basel, Switzerland, June 1977

Postgraduate trainings at different institutions in Switzerland and England

Surgeon-in-chief at the Hospital of Frutigen, Switzerland, 1995-2014

Since 1st September 2014
– surgical consultant at the Venous Centre, clinic Hohmad, Thun, CH
– member of the Medical Insurance Competence-team at lexiatrik, Lucerne, CH
– GP at the Medical Center Arosa, CH

Scientific appointments: PD (Privatdozent)/ Lecturer at the University of Basel
Board member of
-Swiss society for phlebology, SGP
-European Venous Forum, EVF
-Swiss Society for Traumatology and Insurance Medicine, SGTV
-European Society for Trauma and Emergency Surgery, ESTES
-société internationale de traumatologie du ski et médecine des sports d’hiver

Honorary member of:
– Swiss society for surgery, SGC
-Swiss society for general surgery and traumatology, SGACT
-European Society for trauma and emergency Surgery, ESTES

Actual committements: Annual phlebological workshops in Thun, Invited lecturer to phlebological and traumatological congresses, insurance medicine, GP

Married to Simone Heim-Lamezan. Four children: Corsin (34), Mevion (32), Vital (30) and Neira (25). Lives with his family in Frutigen, Bernese Oberland, Switzerland

Contactează operatorul PDI 2025

11 + 5 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro

Prof. Dr. Manfred Herold

Prof. Dr. Manfred Herold

Prof. Dr. Manfred Herold

Prof. Dr. Manfred Herold
Medical University of Innsbruck, Austria

Autoantibodies in connective tissue diseases

Manfred Herold
Medical University of Innsbruck, Austria

The estimated prevalence of autoimmune connective tissue diseases (CTDs) is 3 to 5%. The first line of testing in patients suspected of CTD is screening for antinuclear antibodies (ANAs) , more appropriately defined as anti-cellular antibodies  also recommended on the proposal by International Consensus on ANAPatterns (ICAP) group. The detection of antinuclear antibodies (ANA) is also included in several classification criteria like systemic lupus erythematosus (SLE), Sjogren’s syndrome (SjS), systemic sclerosis (SSc) and mixed connective tissue disease (MCTD). Autoantibodies also assist with the clinical diagnosis of other conditions including idiopathic inflammatory myopathies (IIM) or Juvenile Idiopathic Arthritis (JIA).
A recent survey has shown that indirect immunofluorescence continues to be the predominate technique used for ANA testing in laboratories worldwide and an increasing number of laboratories is using the ICAP classification.
Beside ANAs also non-antinuclear autoantibodies may frequently be observed like anti-Phospholipid (APL), anti-C1q or anti-Ribosomal P autoantibodies in SLE
or anti-α-Fodrin autoantibodies in SjS.
Autoantibodies can be present before any clinical symptoms, but in the majority of cases it is unclear how these autoantibodies are involved in the pathogenesis of CTDs. Nevertheless, autoantibodies can help clinicians for diagnosis.

Scurt CV

Dr. Niazi is board certified in Internal Medicine, Cardiovascular Diseases and Interventional Cardiology by the American Board of Internal Medicine. In addition he is certified in Vascular Medicine Board and in Endovascular Board by the American Board of Vascular Medicine. He has had extensive experience working in some of the leading institutions of the world including USA. He was the first physician who conducted a prospective trial of small vessel stenting was superior to balloon angioplasty in coronary arteries. He joined Emory University in 2003. He has trained many cardiologists and has done mini-seminars in how to do and read non-invasive Doppler techniques for the diagnosis of vascular diseases and complex interventional procedures. He has written two book chapters in Interventional Cardiology 2nd edition on PAD and chronic venous disease. He has pushed cardiologists to look for vascular disease outside the heart. Dr. Niazi is a prolific teacher and besides teaching medical students, residents and cardiology fellows, he has been invited to give lectures, grand rounds locally, nationally and internationally. He has done live demonstration cases demonstrating various endovascular techniques in different countries. He enjoys working with other physicians and learning from them.

Contactează operatorul PDI 2025

11 + 12 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro

Prof. Dr. Niazi Khusrow

Prof. Dr. Niazi Khusrow

Prof. Dr. Niazi Khusrow

Prof. Dr. Khusrow Niazi
Member, American College of Cardiology Competency Management Committee
Professor of Medicine, Emory University, Atlanta, Georgia

What tests to do to identify vascular cause of lower extremity wounds

K. Niazi
Peripheral Vascular Intervention, Emory University, Atlanta, Georgia, USA

Ulcers on the foot or around the ankle area are frequently encountered in clinical practice and carry the ominous danger of limb amputations if prompt diagnosis and treatment is not instituted. Clinically vascular causes may be divided into arterial, venous and others. The most common cause is chronic venous insufficiency (CVI) followed by atherosclerotic arterial occlusive disease also called peripheral arterial disease (PAD). Most of the patients will give a history which will guide the diagnostic testing to confirm the underlying pathology for the ulcer. Physical examination will add to the history in directing what type of vascular testing is performed.
Simple diagnostic testing in the office may help including an ankle-brachial index (ABI) and a Doppler examination of the venous system of the lower extremity. If an abnormal ABI is identified then MRA or CTA of the lower extremities will define the arterial obstructive disease. Majority of these obstructions may be addressed endovascularly without exposing the patient to more invasive vascular procedures. Once the blood flow is improved then with local wound care, healing is expedited. Similarly, once venous insufficiency is demonstrated in the great or small saphenous vein, treating these will expedite wound healing. The treatment is office based thus avoiding any major surgeries.
Venous doppler is an extremely useful test in assessing for chronic venous insufficiency in the lower extremities. The test should be done when the patient is well hydrated and has walked around for 20-30 mins. It should be done with the pt standing as reflux may not be demonstrated with pt lying down.

Endovascular procedures for the treatment of lower extremity wounds

K. Niazi
Peripheral Vascular Intervention, Emory University, Atlanta, Georgia, USA

Once the arterial obstructive disease is confirmed, patient may be referred for revascularization. This may be accomplished endovascularly (percutaneous) or by open surgery using autologous vein or artificial bypass grafts. With advancement of technology, most of the arterial obstruction can be treated endovascularly and it will be dependent on the local expertise. The major advantages of endovascular being that it is less invasive, can be performed as outpatient with very limited morbidity. High risk patients for open surgery can undergo endovascular procedures with less risk.
These days for endovascular treatment there is a plethora of devices at the disposal of the physician treating the patient. The most important factor in deciding how to treat obstruction in the lower extremity arterial disease is for the physician to know their comfort zone with the method they decide to use. The devises available range from simple balloon angioplasty, specialty balloon, atherectomy, LASER, stents and drug coated balloons. Many times, a combination of these devices are employed to treat the obstructive disease. The goal of the therapy is to establish patency and to reduce the risk of re-occlusion.

Scurt CV

Dr. Niazi is board certified in Internal Medicine and Interventional Cardiology by the American Board of Internal Medicine. In addition, he is certified in Vascular Medicine Board and in Endovascular Board by the American Board of Vascular Medicine and is a Fellow of the American College of Cardiology and the Society of Vascular Medicine. He has had extensive experience working in some of the leading institutions of the world including USA. He was one of the first physician who conducted a prospective trial of small vessel stenting and demonstrated that stenting was superior to balloon angioplasty in small caliber coronary arteries as diabetes was very common. He joined Emory University in 2003. He has trained many cardiologists and has done mini-seminars in how to do and read non-invasive Doppler techniques for the diagnosis of vascular diseases and complex interventional procedures. He has written two book chapters in Interventional Cardiology 2nd edition on PAD and chronic venous disease. Dr. Niazi is a prolific teacher and besides teaching medical students, residents and cardiology fellows, he has been invited to give lectures, grand rounds locally, nationally and internationally. He has done live demonstration cases demonstrating various endovascular techniques in different countries.

Contactează operatorul PDI 2025

9 + 10 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro

Prof. Dr. Popescu Iulia

Prof. Dr. Popescu Iulia

Prof. Dr. Popescu Iulia

Prof. Univ. Dr. Iulia Popescu
Allergy and Critical Care Division, Department Medicine, University of Pittsburgh, Pittsburgh, PA

Cutaneous complications – Squamous cell carcinoma of the skin after lung transplant in IPF recipients with short telomeres

Author: Iulia Popescu
Division of Pulmonary Allergy and Critical Care, Sleep Medicine, Department of Medicine,University of Pittsburgh, PA, USA

Rationale: Lung transplant is now an established modality for a broad spectrum of end-stage pulmonary diseases. Lung transplants become more common of post-transplant dermatologic complications. With the increasing use of lung transplant, pulmonologists and dermatologist must be aware of the common as well as the unique posttransplant dermatologic complications, because of immunosuppression, infections, and a variety of medications along with environmental exposures. We describe here the pathogenesis and clinical manifestations of dermatologic complication along with epidemiological characteristics found in lung transplant recipients, with a focus on increased incidence of squamous cell carcinoma (SCC) and in idiopathic pulmonary fibrosis (IPF) patients with short telomeres (TL) who undergo lung transplantation. We have recently shown that short telomeres are common in IPF patients who undergo lung transplantation. Because patients with short telomeres are at increased risk for developing squamous cell carcinoma (SCC), we investigated the incidence of SCC in a retrospective case-control cohort of 144 lung transplant recipients (LTRs). We compared short telomere length (short TL; ≤10th percentile) IPF-LTRs to long TL IPF-LTRs and non-IPF-LTR controls.
Methods: Data were extracted on a retrospective cohort of 72 IPF-LTRs (49 short telomeres, 23 long telomeres) and 72 age-matched non-IPF-LTR controls (median age 63 and 61years, respectively). Lymphocyte and granulocyte telomere length (TL) were measured using flow cytometry and fluorescence in-situ hybridization (flowFISH). Genetic assessment was done using WGS or a targeted sequence panel. TL from WGS was measured using TelSeq software.
Results: A cohort of IPF-LTRs who underwent transplant between 2005 and 2021 was identified retrospectively at our institution, in which flowFISH revealed 49/72 (68%) had short TL. TelSeq from WGS samples revealed a significantly shorter TL for the IPF-LTR cohort compared to the age adjusted mean (p<0.001). Genetic characterization for the 7 telomere maintenance genes showed that 19/72 (26%) IPF-LTRs had rare variants in the telomere associated genes and all 19 had short-TL. IPF-LTRs had a significantly higher incidence of developing SCC post-lung transplant with30/72 (42%) compared to non-IPF LTRs 9/72 (13%) p=<0.0001. Among the IPF-LTRs, short-TL IPF-LTRs had increased occurrence of SCC compared to long-TL IPF-LTRs (p=0.0042). There was no significant difference in squamous cell carcinoma diagnosis in IPF-LTRs with an identified rare gene variant (47% vs 36%; p=0.3769). Short-TL IPF-LTRs were more likely to have immunosuppression agents discontinued from three to two drug regimens due to cytopenia’s compared to non-IPF controls (p=0.0375). IPF-LTRs with squamous cell carcinoma were more likely to have immunosuppression agents discontinued from three to two drug regimens compared to non-IPF controls (77% vs 44%; p=0.0662). There was no significant difference in mortality due to squamous cell carcinoma between IPF-LTRs and non-IPF controls (p=0.1447), however all 6 IPF mortalities had short-TL (6/26; 23%) with 3/6 (50%) having a rare variant and immunosuppression discontinued.
Conclusions: IPF-LTRs with short-TL are at increased risk of developing squamous cell carcinoma post-transplant and these patients had higher incidence of immunosuppression medications discontinuation and higher mortality rate. Therefore, telomere length measurement is useful in identifying these IPF-LTRs at risk for developing post-transplant squamous cell carcinoma.

Short CV

I am a Associate Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pittsburgh in Dr. John McDyer’s laboratory. I have significant experience in transplant and viral immunology. My work has focused on T cell mechanisms of rejection, tolerance, and host immunity to viruses such as CMV, EBV and HIV, including the measurement of lung mucosal responses. I have focused on CMV-specific T cell immunity in lung transplant recipients in a leading clinical transplant program. I am CO-I on a U01 award (AI125050-Dr. McDyer) to perform a novel clinical trial to perform tandem lung and bone marrow transplantation in select individuals with primary immunodeficiencies and end-stage lung disease, and to perform mechanistic pathogen-specific and alloimmune tolerance studies in these study participants. In U01AI125050 I measure systemic and lung pathogen-specific immune responses. As immunologist my focuses are on mechanisms of CMV-specific lung mucosal/systemic immunity and viral control, demonstrating an important role for the Type-1 transcription factor T-bet and other immune parameters. I also study immune mechanisms of allograft rejection/tolerance in lung transplantation with an established divisional research group performing studies in the human studies. I also perform work on Dr. McDyer and Dr. Kirks’ collaborative U01 award (HL121814) to study immune mechanisms of HIV-associated COPD. I am the Co-I on an R01 award HL133184-01 (Dr. McDyer), “Role of F-box Proteins in Lung Transplantation.” In addition, common to these experimental systems above, Dr. McDyer’s laboratory is highly proficient in measuring lung mucosal and systemic viral-specific and allospecific multifunctional T cell immunity and phenotyping in lung transplant recipients. I have a good track record of training medical students and fellows and junior faculty in Dr. McDyer’s lab. the field of lung transplant immunology. Pertinent to this proposal I also have significant experience assessing human alloimmunity, using flow cytometry, in addition to viral immunity, and evaluate the phenotype of T cells, proliferation and effector multifunction. In addition, I am very experienced in ELISA and ELISPOT assays to measure inflammatory responses. Recently, we showed that IPF lung transplant recipients with short telomeres have impaired CMV T cell immunity. Here at Pitt, Dr. Alder, Dr. Snyder, Dr. Chen, Dr. Iasella and Dr. Popescu have a track record of working closely together. Therefore, based on my established and current role in Dr. McDyer’s laboratory and my expertise in transplant immunology in the field of lung transplantation makes me well-suited to fulfill my role as Co-I on this project R01 project, “The Role of Telomeres in Lung Transplant Recipient Immunity and Outcomes”.

EDUCATION and TRAINING
1981-1985 – C.A. Rosetti – Bachelor of Science, 1985, Biology-Chemistry Bucharest, Romania
1986-1992 – Polytechnic University Master’s Degree, 1992, Faculty of Chemistry Bucharest, Romania
1996-2000 – University of Bucharest, Ph.D. in Life Science 2000, Faculty of Chemistry, University of Bucharest, Romania
2000-2001 – Research Scientist III – Dept. of Cellular, Immunology and Signal Transduction, Centre of Immunology, Institute of Virology, Bucharest, Romanian
2001-2006 – Postdoctoral Research Associate – University of Pittsburgh, Dept of Surgery
2010-2012 – Sr. Staff Scientist/Technical Application Specialist, Cellular Technology, Limited, CTL, Shaker Heights, OH
2/2012-4/2014 – Visiting Research Associate/ Manager Flow Cytometry Core, Division of Pulmonary, University of Pittsburgh, Pittsburgh, PA, USA
5/2012-6/2014 – Research Associate / Manager Flow Cytometry Core Division of Pulmonary, University of Pittsburgh

APPOINTMENTS and POSITIONS ACADEMIC
5/2006-9/2006 – Visiting Research Instructor of Surgery, Dept of Surgery, University of Pittsburgh
10/2006-4/2010 – Research Instructor of Surgery, Dept of Surgery, University of Pittsburgh
7/2014-3/2015 – Visiting Research Assistant Professor of Medicine/ Manager Flow Cytometry Core, Division of Pulmonary, University of Pittsburgh
4/2015-3/2020 – Research Assistant Professor of Medicine, Division of Pulmonary, University of Pittsburgh
3/2020-present – Research Associate Professor of Medicine, Division of Pulmonary, University of Pittsburgh

MEMBERSHIPS in PROFESSIONAL and SCIENTIFIC SOCIETIES
-Member – American Society of Transplantation (AST) 2006-present
-Member – American Immunology Association (AIA) 2007-present
-Member – European Association for Cancer Research (EACR) 1998-present
-Member – Federation of European Biochemical Societies (FEBS) 1990-present
-Member – Romanian Society of Immunology (SNI) and Dermatology 1986-present
-Member – International Society of Heart and Lung Transplantation 2019-present

Contactează operatorul PDI 2025

3 + 8 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro

Prof. Dr. Röcken Martin

Prof. Dr. Röcken Martin

Prof. Dr. Röcken Martin

Prof. Dr. Röcken Martin
Eberhard Karls University, Tübingen, Germany

Risk of cancer and opportunistic infections: JAK inhibitors versus biologics

Autor: M. Röcken
Department of Dermatology, Eberhard Karls University Tübingen, Germany

Many immune responses, such as the control of viral infections are critically controlled by cytotoxic T cells (CTL) and by natural killer cells. Because of this, it was long believed that inflammatory and autoimmune diseases are also mainly caused by cytotoxic T cells. For some diseases, like alopecia areata, this is still the prevailing concept.
The identification of first the innate cytokines interleukin (IL-) 1 and tumor necrosis factor (TNF) and then of the T cell cytokines IL-2, interferon (IFN-) g, IL-4, IL-5 and IL-13 strongly suggested that these cytokines critically determine the outcome of both, innate and adaptive immune responses.
The proof-of-concept experiment for the relevance of T cell cytokines in inflammatory diseases was first provided in a model disease for multiple sclerosis, the experimental autoimmune encephalitis (EAE) in mice. In this model disease it was first shown that autoreactive, pro-inflammatory CD4+ T helper cells can cause this autoimmune disease. Moreover, it was shown in vivo that it is possible to deviate the autoreactive proinflammatory CD4+ T helper cells, that produce IFN-g and IL-17, into autoreactive Th2 cells that produce IL-4. This immune-deviation, the induction of autoreactive Th2 cells is a highly efficient therapy of EAE.
Later this IL-4 based therapy of EAE in mice was translated into an IL-4 based therapy of psoriasis. This study provided the proof of concept, that modulation of T cell cytokines can be highly efficient as therapy for human autoimmune diseases. As most cytokines have a short half live in vivo, the industry focused on the modulation of T cell cytokine responses not with cytokines but with antagonistic monoclonal antibodies. Today, many of these novel antibody-therapies were first developed for the treatment for either psoriasis or atopic dermatitis. Now, they have been approved for a large spectrum of inflammatory diseases. The safety concerns depend on the actions of the cytokine that are attenuated. They are well predictable as they affect a well described spectrum of signaling pathways. When used correctly, most cytokine antagonists can safely be used.
As it became clear that many cytokines signal their message to the nucleus through Janus kinases (JAK), JAK inhibitors (JAKi) were developed. JAKi have the advantage of being orally applicable small molecules. JAKi initiated a second revolution in the therapy of autoimmune and inflammatory diseases, with a profound impact on dermatology and rheumatology. However, their clinical success has been accompanied by an increasing number of safety concerns, that warrant careful consideration. This is at least in part due to the effect that more than 20 cytokines mediate their message to the nucleus through as little as four JAK molecules. In consequence, JAKi are never as specific as cytokine antagonists., like monoclonal antibodies. Importantly, three of the four JAK are critically involved in the signaling of the various IFN molecules – cytokines that are essential for the immune responses against viruses, intracellular pathogens and tumors. In consequence, the safety concerns associated with JAKi include a greater susceptibility to viral diseases, mycobacterial infections, and cancer, a potential association with thrombosis, and, in certain patient populations, increased mortality. As a response to these concerns, regulatory agencies, like the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have published warnings, jointly with important pharma companies.

Treating inflammatory skin diseases under financial restrictions

Autor: M. Röcken
Department of Dermatology, Eberhard Karls University Tübingen, Germany

In 2002 it was first shown that psoriasis can efficiently be treated by modifying potentially harmful cytokines produced by T lymphocytes or by antigen presenting cells. In this proof of concept manuscript psoriasis was successfully treated with interleukin 4, a cytokine that impairs the production of IL-23p19 in antigen presenting cells (Ghoreschi K et al. Nature Medicine 2002). Since this proof of concept showing that soluble mediators produced by immune cells can cause inflammatory and autoimmune diseases, multiple therapies were developed to attenuate or block the functions of cytokines. Psoriasis and atopic dermatitis were frequently the first diseases where such cytokine antagonist have been shown to be effective, and they are currently heavily propagated during medical society meetings, in guidelines, and by the industry. While efficient for many diseases, these treatments are marketed at extraordinary high prices and are a major burden for those affected or health care systems. It is therefore time to re-evaluate the efficacy, safety and availability of less expensive drugs, two being methotrexate and glucocorticosteroids.
Controlled trials published over the past 25 years demonstrate that methotrexate is as efficient as cyclosporin A in treating either psoriasis or atopic dermatitis. Methotrexate should not be given to pregnant women and not taken while planning to get children. Otherwise, if applied correctly, 15 mg to 20 mg methotrexate per week are not associated with the metabolic side effects of cyclosporin A and does not sensitize for UV-induced skin cancers. There some few and severe disease conditions where defined cytokine antagonists are much more efficient than methotrexate, such as Hallopeau type or joint psoriasis. Yet, under most conditions, methotrexate seems to be similar effective as the most expensive novel therapies – and in case of very severe atopic dermatitis a short comedication for 2-4 weeks of methotrexate and glucocorticosteroids also strongly improves the most severe manifestations. Importantly, systemic glucocorticosteroids have to be strictly limited to this time. As, in addition methotrexate has an excellent long-term safety, most severe inflammatory skin disease can efficiently and safely be treated at relatively low costs – independent of whether patients are wealthy or have financial restritions.

Scurt CV

Education and academic career
1976 – 1983 Medical Studies, Freie Universität Berlin (Germany), Université Libre de Bruxelles (Belgium, 1976 – 1977), Université de Lausanne (Switzerland, 1980 – 1981) and Universität Bern (Switzerland, 1982 – 1983)
1984 – 1988 Medical training and Consultant, Department of Dermatology and Allergology, City Hospital Munich Schwabing, Teaching Unit of the Ludwig-Maximilians-Universität München (Germany)
1988 – 1991 Research grant of the Deutsche Forschungsgemeinschaft, Department of Dermatology, Université de Genève (Switzerland)
1991 – 1993 Visiting Associate, Laboratory of Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (USA)
1993 – 1998 Assistant Professor, Medical Faculty, Department of Dermatology and Allergology, Ludwig-Maximilians-Universität München (Germany)
1998 – 2002 C3 Professor for Dermatology and Venereology, Medical Faculty, Department of Dermatology and Allergology, Ludwig-Maximilians-Universität München (Germany)
2002 – 2024 C4 Professor for Dermatology and Venereology and Chairman, Medical Faculty, Department of Dermatology, Eberhard Karls Universität Tübingen (Germany)

Clinical and experimental focus
● Tumor immune therapy, tumor immunology
● Autoimmune diseases of the skin and psoriasis: Pathogenesis and novel therapies
● Allergology
● Pathogen-host-interactions during infectious diseases in immune-competent and
immune-compromised hosts, HIV-infection
● Immunology
● Translational medicine

Memberships, faculty positions and editorial boards
JDDG, British Journal of Dermatology, Journal of Investigative Dermatology, Acta Dermatovenerologica (Scandinavia)
Arbeitsgemeinschaft Dermatologische Forschung (ADF), Board of Directors and Secretary Treasurer
European Dermatology Forum (EDF)
European Society for Dermatological Research (ESDR), Board of Directors, President and Secretary Treasurer
Deutsche Dermatologische Gesellschaft (DDG, German Dermatological Society), Board of Directors, Executive Council and Secretary Treasurer
Deutsche Forschungsgemeinschaft (DFG), Vice Chairman of Review Board „Sektion 1: Entzündungsforschung“ (inflammation research)
The German Academy of Sciences Leopoldina
Alfred-Marchionini-Stiftung zur Förderung der medizinischen Wissenschaft
European Skin Research Foundation (ESRF), Board of Trustees
European Academy of Dermatology and Venereology (EADV), Board of Directors,
Executive Committee, Representative of the Board (2012 – 2014),
Chairperson Scientific Programming Committee (2013 – 2018),
President Elect (2020 – 2022), President (since 09/2022)
Honorary Member of the French Society for Dermatology
Academia Europaea (The Academy of Europe)
Honorary Member of the Austrian Society of Dermatology and Venereology
Corresponding Member of the Swiss Society of Dermatology and Venereology
International League of Dermatological Societies (ILDS), Board of Directors,
Chair of the Scientific Programme Committee „World Congress of Dermatology 2023“
Honorary Member of the Società Italiana di Dermatologia
Honorary Member of the European Society for Dermatological Research
Honorary Member of the Sociedade Portuguesa de Dermatologia e Venereologia
Honorary Member of the Swiss Society of Dermatology and Venereology
Honorary Member of the Colegio Ibero Latino Americano de Dermatología

Contactează operatorul PDI 2025

7 + 14 =

Operatorul PDI 2025

Adresa: Str. A. Panu nr. 13, Iasi
Tel.: 0332.40.88.00-04
E-mail: contact@pdi.ro
Website: www.eventer.ro