IT’S ‘BOUT DAMN TIME!

Postponed since 2020, we were finally able to resume our annual meeting this past May, traveling to Germany and Austria! Many thanks to Dr. and Mrs. Benedetto for their insight and planning, Jodi Murphy and Carla de Bejar of Cruise and Travel Partners for keeping the trip intact the past three years, and Drs. Valentine and Mehregan for coordinating our scientific sessions!

We began in Munich, enjoying the luxurious Bayerischer Hof Hotel. After arrivals, a brief city tour was followed by dinner at the Ratskeller. Our first set of meetings began the next day at the Ludwig-Maximilians Universitat Munchen, active since the 1500s and where renowned Dr. Gerd Plewig recounted its celebrated history. Drs. Prinz and French described their research into gene function, identifying a protein found on melanocytes that may represent a trigger for CD8 T-cells in psoriasis, and utilizing RNA transcriptome analysis in certain conditions to identify therapeutic options. A case of chronic rubella infection causing necrobiosis lipoidica-type lesions in a patient with HLA class 1 deficiency disease, as well as a case of atypical toxic epidermal necrolysis in a child after stem cell transplant for STAT-1 deficiency caused by Coxsackie A6 were presented. After the meeting we were treated to rickshaw rides though the city, ending at the president’s welcome dinner at Seehaus waterfront restaurant.

The next day, we met at the Technischen Universitat Munchen where Dr. Mehregan discussed the use of PRAME staining to aid in melanoma diagnosis. Dr. Springer proposed a classification of inflammatory skin disorders using cytokine and T-cell subsets. Dr. Schmidle explored using immune staining, RNA and DNA analyses of hidradenocarcinoma to identify treatment options. Dr. Mathes described the risk of allergy to Covid vaccination to exposure with polyethylene glycol, with the higher molecular weight becoming more allergenic. Wonderful department tours and interactions were held at both clinics. After the meeting we were taken through various food markets in Munich and had lunch at a biergarten. After lunch the groups either toured the BMW museum, the Bavarian national museum or the Dachau camp memorial.

The group then traveled to Kitzbuhel, Austria visiting Neuschwanstein and Linderhoff castles, staying at the fabulous Kempinski Tyrol Hotel, where the next morning Dr. Valentine described the rich history of German dermatology. Dr. Ramsay (Elizabeth Abel, MD Lecturer) gave an outstanding review of stasis ulcers, from risk factors to diagnosis and therapy. Dr. Hartley described the use of telemedicine to help diagnose and organize therapy in remote corners of the world where medical care is scarce. Dr. Stone discussed a case of refractory psoriasis due to a CARD 14 gene mutation, blue grey skin discoloration from imipramine and sun exposure, and aquagenic wrinkling of the hands. Dinner was at Rosi’s Sonnbergstuben, a wonderful family restaurant where we were serenaded by the Rosi’s yodeling.

We then visited the State Hospital Salzburg where Dr. Bauer discussed their research into epidermolysis bullosa, where the EB Haus, a special facility dedicated to EB is located. He discussed progress in gene therapy. After lunch in Salzburg, we traveled to Berchtesgaden, staying at the Kempinski Hotel. Dinner was at the Berggasthof Obersalsberg where we were treated to a magical sunset in the alps, as well as an accordion accompaniment, with Jodi and Carla dressing enchantingly in local attire.

Dr. Stewart started the next day’s meeting with a discussion about Artificial Intelligence in medicine, followed by a discussion from Dr. Bryg concerning prior authorizations in his health care system (Kaiser).Dr. Berger discussed the current climate for practice sales as compared to several years ago as well as what may be next. Dr. Sterling gave a thorough discussion of JAK inhibitors for vitiligo, as well as future therapies based upon cytokine and genetic research. A panel discussion was held regarding challenging closures with various dressings.

The group then ascended to 1.8k meters (6k ft) to the Eagle’s nest, which while built for Hitler, he rarely visited due to fear of heights. Lunch at the biergarten (est 1938) with panoramic views of the Alps capped the visit. The last set of lectures was started by Dr. Curcio who reviewed botulinum toxin with emphasis on the new product daxibotulinotoxin, which may last longer, has no albumin, and can be stored at room temperature. She also described the importance of business plans, marketing, websites, and social media use. Dr. Hodge discussed TLC (trust, listening and compassion) to enhance the patient-provider relationship that has changed drastically over the past few years. Dr. Benedetto discussed vascular complications from fillers as well as rescue plans should one occur. Dr. Mehregan discussed the challenges pathologists incurred due to electronic records as well as several interesting cases from Wayne state. Dr. Hamill closed the meeting with a discussion about wound healing, complications and the outcomes anticipated by elderly patients vs younger patients as well as the difficulty in coordinating care for the elderly, many of whom live alone.

At the annual members’ meeting, a wonderful itinerary for Peru in 2023 was discussed with a pre-tour to the Galapagos and a post-tour through the Andes. Currently set for May of 2023, with final dates pending. The meeting is scheduled to be May 22nd to June 1st, 2023 and it looks to be yet another fabulous time!

Our farewell dinner was held at the mischievous Hellbrunn Palace, where more than one of us was surprised by hidden fountains. A very special treat was enjoyed by all as our local guide’s very talented wife, who sings for the opera, sang several numbers and his 6-year-old daughter played a piano duet with him. Many of us enjoyed the dance floor as well. All made it home safe ‘n sound, although there was a rumor that some may have used hand sanitizer intranasally to avoid a positive Covid test……

As the title states: It’s ‘bout Damn Time! – we can renew friendships, meet with colleagues and travel once again. I so look forward to seeing all in Peru! More details regarding next year’s meeting are on the website. All be safe and enjoy precious time with loved ones, friends, and colleagues!

All the best to all-

Robert S. Berger, MD
President


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