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86th Annual Meeting of the British Association of Dermatologists

The 86th Annual Meeting of the British Association of Dermatologists took place at Manchester ICC 4th - 7th July 2006.

Report by Richard Weller (Edinburgh)

The 2006 Annual Meeting of the BAD was blessed by glorious weather and a high turn out. Over 900 dermatologists and dermatological nurses were easily absorbed by the capacious Manchester International Convention Centre with posters and trade stands displayed in the adjacent G-Mex exhibition centre. It was my first BAD meeting for a number of years and I was struck by the way it has evolved into such a practical blend of teaching, research presentations and of course the highlights of the invited speakers.

A few themes struck me in particular. Professor Dame Carol Black, the outgoing president of the RCP (London) gave a thought provoking talk on the role of the RCP on the Tuesday evening. The college has clearly undergone fairly significant restructuring in the last few years dictated by the changing nature of medical practice and gradual replacement of the the traditional general physician with specialist physicians. The concerns of some dermatologists as to how well we are represented by the RCP, and which have prompted thoughts of forming a faculty, have been felt by other medical specialities as well. The RCP is evolving in response to this giving more weight to individual medical specialities and becoming more of a confederation than a monolith. I at least was encouraged by this message.

The AGM was quite an eye opener to a Scottish dermatologist. Things really have changed south of the border.English dermatologists clearly have to fight their corner to a degree that we have not yet experienced in Scotland. I will now watch managerial changes up here with considerably more trepidation than previously.

A pleasingly unifying clinical theme was the significance of inadequate barrier function in eczema. Professor Hovnanian gave a beautiful exposition of his work on Netherton’s syndrome in which mutations in SPINK5 lead to a defective serine protease inhibitor. This leads to a severe skin barrier defect, erythroderma and eczema. Hot off the press, Alan Irvine presented his and Irwin McLean’s findings that mutations in the fillagrin gene cause icthyosis vulgaris, and that this in turn is strongly linked with atopic eczema. Once again the suggestion is that a barrier defect allows antigens to pass the skin barrier and precipitate eczema. To restore a bit of balance, and reassure us that eczema treatment isn’t purely a matter of applying emollients Mike Arden-Jones spoke on superantigen-allergen synergy. Staphylococcal enterotoxin augments the response of T cells to allergens, and this helps explain why it is that infections so worsens eczema. This had won the prize for best registrar’s presentation at the BSID.

As a fairly low tech clinical researcher I particularly enjoyed work from Southampton showing the use of microdialysis to investigate percutaneous drug absorbtion. Equally good, if rather more molecular, was the description of the development and refinement of pre-implantation genetic testing for various forms of EB by Fassihi. Leslie and colleagues characterised the phenotype of the rare inflammatory condition cryopyrinassociated periodic syndrome, and showed that anti-interleukin 1 produced a symptomatic remission. Fittingly all three of these papers received prizes.

In the registrars and professors session we heard how to do it from a number of our elders and betters. Approaches to research varied from from clinician-scientists Peter Mortimer and Fenella Wojnarowska concentrating on clinical approaches to a particular problem to Julia Newton-Bishop running a multinational group using large populations to determine genes and mechnisms of interest.

I was sorry to miss the BSF walk. First of all a praiseworthy charity, and one which we should all support- and secondly a beautiful evening for a stroll along the canal past much of Manchester’s industrial heritage. The other regret was having arrived too late for Philip Mckee’s talk on the changing face of dermatopathology which sounded fascinating. The drinks reception at Manchester art gallery gave the opportunity to catch up with old friends, and take ones fill of high Victorian art. All in all, a highly enjoyable meeting.

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