MASTERCLASS. Part V: Dermatology Session. RCPI Masterclass Series 2009/2010 Treating the Acutely Ill Patient Update and advances

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1 MASTERCLASS Royal College of Physicians of Ireland No. 6 Kildare St, Dublin pm Wednesday, April 7, 2010 RCPI Masterclass Series 2009/2010 Treating the Acutely Ill Patient Update and advances in management of common medical conditions presenting on call Part V: Dermatology Session

2 Welcome Dr John Donohoe President, RCPI Dr Diarmuid O Shea Masterclass Series Convenor, RCPI Dear Delegates, In line with its mission to promote excellence in medical education and to support the advancement of the medical profession, we are pleased to welcome you to today s meeting the Dermatology session of the RCPI Masterclass Series on Treating the Acutely Ill Patient. The RCPI Masterclass Series which will run over seven sessions from October 2009 through to June 2010 is aimed at keeping doctors up to date in evolving medical practice outside their specialty area and to facilitate their continuing medical education. The objective of the series is to help those who are at the front line of our health service continuously improve their skills base, effectively facilitating excellence in patient care. The series brings together medical experts from a variety of specialties under a central theme, provides a senior forum for peer discussion and has in the past attracted unprecedented numbers for Irish training. The entire series will be webcast live to 26 regional hospitals and will also be available as a recorded webcast via the RCPI s Online Education and Resource Centre. We would like to thank the chairs of this session, Dr Gillian Murphy and Dr Pauline Marren, and the speakers for their contribution to the programme and the series. Each session qualifies for 3 CME credits from RCPI (21 in total for the series). If you have suggestions for future topics in the series include them on the assessment form in your meeting pack. Alternatively, your suggestions to us at helenmurray@rcpi.ie. We hope you enjoy the meeting. Dr John Donohoe President Royal College of Physicians of Ireland Dr Diarmuid O Shea Vice President for Education and Professional Development Royal College of Physicians of Ireland

3 Programme: Wednesday, April 7, 2010 TIME TITLE SPEAKER CHAIR Registration Management of patients with immunobullous diseases Dr Tony Egan, Our Lady of Lourdes Hospital, Drogheda Question and Answer Session A S.A.L.T. y tale Question and Answer Session Dr Sinead Field, Beaumont Hospital, Dublin Dr Gillian Murphy, Beaumont Hospital, Dublin Skin Failure a complication of psoriasis Dr Trevor Markham, University College Hospital, Galway Question and Answer Session Refreshments Pyoderma gangrenosum associated with underlying diseases Dr Frank Powell, Mater Hospital, Dublin Question and Answer Session Porphyria - the great masquerader Dr Gillian Murphy, Beaumont Hospital, Dublin Dr Pauline Marren, University College Hospital, Galway Question and Answer Session Panel Discussion This meeting is approved for 3 CME credits by the Royal College of Physicians of Ireland

4 Chairpersons Dr Gillian Murphy, Beaumont Hospital, Dublin Dr Murphy will chair Session 1 Gillian Murphy is Consultant Dermatologist in Beaumont and Mater Hospitals Dublin. She is also Director of the National Photodermatology Service, and runs a research programme into the effects of Ultraviolet Radiation on the skin. She has had a special interest in Photosensitivity diseases including the porphyrias and wrote her MD Thesis on the Photodermatoses. Her experience, at a clinical and research level, of these disorders has resulted in very numerous publications in peer reviewed journals and text-books. She is an invited speaker on these topics at the American Academy of Dermatology, the European Academy of Dermatovenereology, The World Congress of Dermatology together with numerous other international and national societies. She is current President of the Irish Association of Dermatologists, past-president of the British Photodermatolgoy Group, Treasurer of the European Society of Photodermatology and Board member of the American Photomedicine Society. Dr Pauline Marren, University College Hospital, Galway Dr Marren will chair Session 2 Pauline Marren is Consultant Dermatologist and Clinical Lecturer at University College, Galway. Dr Marren is a graduate of University College Hospital Galway and completed specialist training in Oxford, England.

5 Session Management of patients with immunobullous diseases Dr Tony Egan, Our Lady of Lourdes Hospital, Drogheda Biographical Sketch Tony Egan is Consultant Dermatologist at Our Lady of Lourdes Hospital, Drogheda. He earned his medical degree from University College Dublin in 1990 and completed his early training in Dublin and Minneapolis. He spent four years as a dermatology resident at the University of Utah, where he completed an MD degree. Dr Egan subsequently completed a two year fellowship in dermatology at the NIH, in Bethesda Maryland. In 1999, he became a Diplomate of the American Board of Dermatology. He has published widely on various aspects of immunobullous disease including: linear IgA bullous dermatosis, bullous pemphigoid, and anti-epiligrin cicatricial pemphigoid. Overview of Presentation This presentation will focus on the immunopathology and clinical features of immunobullous diseases. This will include discussion of pemphigus, bullous pemphigoid and its subtypes, as well as rarer but acutely life threatening immunobullous disorders. The main topics covered will include clinical recognition, laboratory diagnosis and treatment of theses diseases. Special emphasis will be placed on initial management in the acute hospital setting. Recognition and management of acute complications of these diseases will be emphasised.

6 A S.A.L.T. y tale Dr Sinead Field, Beaumont Hospital, Dublin Biographical Sketch Sinead Field is Year 3 Dermatology SpR. She presently working in Beaumont Hospital and has a special interest in malignancy of the skin. She has received a very prestigious competitive research grant (The Bramall Fellowship) to carry out a research project on Malignant Melanoma in Leeds University UK in the forthcoming year. She has published widely in peer reviewed journals. Dr Field will complete her Royal College of Surgeons in Ireland Postgraduate Diploma in Leadership and Management Development for Healthcare Managers and Doctors in June Overview of Presentation Cutaneous lesions of lymphoma may represent either primary skin lymphoma or reflect the presence of systemic lymphoma. This presentation reviews these aspects of lymphoma and the classification of such diseases.

7 Session Skin Failure a complication of psoriasis Dr Trevor Markham, University College Hospital, Galway Biographical Sketch Trevor Markham qualified from University College Dublin in He trained on the first higher specialist training scheme in Dermatology in Ireland from In 2002 he obtained a HRB Clinical and Research Fellowship and was awarded a MD by University College Dublin, in 2004, for research into the effects of anti TNF alpha agents on angiogenesis in psoriasis. Having worked as a Consultant Dermatologist in Bristol Royal Infirmary he returned to University Hospital Galway as a Consultant and Clinical lecturer. His main areas of interest include psoriasis and phototherapy. Dr Markham is currently the Honorary Secretary of the Irish Association of Dermatologists. Overview of Presentation Erythroderma is a serious and sometimes fatal condition which general physicians need to be able to recognise. A number of dermatoses can result in this common final pathway of skin failure. This presentation will focus on the main differential diagnoses of erythroderma and the emergency management of these patients. Particular emphasis will be placed on the diagnosis and management of erythrodermic psoriasis.

8 Session Pyoderma gangrenosum associated with underlying diseases Dr Frank Powell, Mater Hospital, Dublin Biographical Sketch Frank Powell is a Consultant Dermatologist at the Mater Hospital, Dublin. Dr Powell, who graduated from University College Dublin in 1975, is a Fellow of the Royal College of Physicians of Ireland and the Royal College of Physicians of Edinburgh. His research interests include Rosacea and Pyoderma gangrenosum. Overview of Presentation Information not available at time of print.

9 Session Porphyria - the great masquerader Dr Gillian Murphy, Beaumont Hospital, Dublin Biographical Sketch Gillian Murphy is Consultant Dermatologist in Beaumont and Mater Hospitals Dublin. She is also Director of the National Photodermatology Service, and runs a research programme into the effects of Ultraviolet Radiation on the skin. She has had a special interest in Photosensitivity diseases including the porphyrias and wrote her MD Thesis on the Photodermatoses. Her experience, at a clinical and research level, of these disorders has resulted in very numerous publications in peer reviewed journals and text-books. She is an invited speaker on these topics at the American Academy of Dermatology, the European Academy of Dermatovenereology, The World Congress of Dermatology together with numerous other international and national societies. She is current President of the Irish Association of Dermatologists, past-president of the British Photodermatolgoy Group, Treasurer of the European Society of Photodermatology and Board member of the American Photomedicine Society. Overview of Presentation The porphyrias arise as a consequence of perturbation of the activity of enzymes involved in the haem biosynthetic pathway. Each one of these enzymes when deficient leads to a different porphyria type. Much is now understood about factors leading to acquired forms of porphyria and the genetic basis of the porphyrias is now relatively well characterised. New types of porphyria have been recognised, in particular, late onset porphyrias have been linked to underlying haematological dyscrasias. Appropriate investigation of these porphyrias should be undertaken and management targeted accordingly. Some porphyrias are now curable by bone marrow transplantation. Management of the symptoms of some porphyrias may be significantly improved by liver transplantation, but in erythropoietic protoporphyria photosensitivity continues. Cutaneous porphyria may be a manifestation of underlying disease accurate diagnosis and classification leads to best management practice. A subset of the porphyrias are of particular importance as acute attacks may occur, the presentation of acute attacks may cause great clinical confusion, awareness of the clinical pictures which may represent the first presentation of porphyria leads to early diagnosis and appropriate intervention.

10 UPCOMING SESSIONS in the 2009/2010 RCPI Masterclass Programme will take place from to on the following dates: Part VI: Endocrinology 5 May 2010 Part VII: Nephrology 2 June 2010