Skin Deep - Clinical & Cosmetic Dermatology Blog

Skin Deep is a blog for dermatologists and skin care professionals with focus on theoretical, cosmetic and aesthetic dermatology. This blog is associated with ‘Dermatologists Sans Borders’ one of the largest curated groups of skin care professionals on facebook. If you are looking for non-technical information, please visit http://skinhelpdesk.com


Systemic Sclerosis, Raynauds and Lupus

Attended the Systemic Sclerosis, Raynauds and Lupus CME by Hamilton Scleroderma Group
at Sheraton on Friday, 27 September 2013. I missed the panel discussions in the morning. This was my first CME in North America.
Clinical appearence of acrosclerotic piece-mea...
Clinical appearence of acrosclerotic piece-meal necrosis of the first digit in a patient with systemic sclerosis. (Photo credit: Wikipedia)

The take home message from Dr. Michael Walsh's talk on Scleroderma Renal Crisis was the adage “Time is Kidney”. He also stressed the need to be cautious about the use of Steroids when a renal involvement is suspected/expected. My memories of SS management dates back to the late nineties, when we (mostly in India) used to consider dexamethasone pulse therapy as the gold standard for treatment of Diffuse cutaneous systemic sclerosis (dcSSc). Are there any renal involvement prediction algorithms in SSc?

Dr Rebecca Amer spoke about the various types of Pulmonary Hypertensions and the risk factors. As we dermatologists are aware, PH is more common in the limited cutaneous type of SSc. However the highlight of her talk was the importance of right heart catheterization (RHC) in the severity assessment.

English: Pulmonary fibrosis induced by amiodarone.
English: Pulmonary fibrosis induced by amiodarone. (Photo credit: Wikipedia)
Prof. Gerard Cox gave a very entertaining and thought provoking talk on pulmonary fibrosis. The take home message from his talk was “treat only if necessary”. He also highlighted the paradox of honeycombing being a better prognostic indicator in SSc induced pulmonary fibrosis. He also stressed the role of methotrexate (MTX) as a causative agent of pulmonary fibrosis. In India MTX is extensively used by dermatologists for the treatment of psoriasis and its complications, but pulmonary fibrosis is not very frequent. Unfortunately he did not comment on the theories of fibrosis, one of my areas of interest. I have started a mindmap for fibrosis here. Take a look and please contribute if you can.

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About Me

As a Dermatologist and Informatician my research mainly involves application of bioinformatics techniques and tools in dermatological conditions. However my research interests are varied and I have publications in areas ranging from artificial intelligence, sequence analysis, systems biology, ontology development, microarray analysis, immunology, computational biology and clinical dermatology. I am also interested in eHealth, Health Informatics and Health Policy.

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Bell Raj Eapen
Hamilton, ON
Canada