Today is a busy day – all the last minute things before the off for Buenos Aires early tomorrow.

I have said enough about what to expect and who to go and see – so here’s a few practical and light-hearted tips gleaned years of travel and from disasters, potential disasters and disasters.

Flights

• Save time and check-in on line. Don’t forget if you are travelling via the US (even in transit) passport details are needed. Use the Bag Drop – much quicker (some anglo-saxon airline excepted !!)
• Check the luggage allowance – I found that transatlantic flights can be surprisingly generous. My flight allows three pieces of luggage each up to 32 kg. More than enough for the wife’s jewellery !
• If you have time – buy a “suiter” – so much better for the posh frocks and suits. Avoids looking like you travelled in the hold when you arrive at the Opening reception.

Hotels

• Check that you DO have a reservation. You should have a reference number from your agent. My reservation was a potential disaster – no bed for the day I arrive. Thanks to P&G’s splendid administrators – sleeping on the streets was averted.
• Be nice to the concierge and he or she will take good care of you

Taxi from the Airport

• The taxi company number for the Remises (located just beyond Customs) did not have anyone who spoke English (or presumably any other language – American, Australian etc)
• Phone your hotel and/or e-mail them asking them to arrange a taxi. Don’t forget the return. Tip the driver about 10%
• If you don’t manage to do this – outside the airport go to the Taxi Stand and wait for a black and yellow “Radio Taxi” – make sure it has a meter.

Money

• Get local currency when you arrive for best rates. However , apparently ATMs are NOT everywhere but there is bound to be one near your hotel
• Have a few dollars with you and use your credit card to pay for the reserved taxi
• Only about 75% of restaurants take credit cards but most shops do
• US dollars are acceptable as tips

Language

• For first time visitors to Argentina – this is not a country in which English is widely spoken – as I found out to my cost. Learn some key words – and remember that the language is influenced by the large Italian population – don’t say gracias : its Chau (like ciao).
• Buy a local Spanish/English dictionary and learn to smile and point.

Cultural Sensitivity

• Read “A short history of the Argentines” by Felix Luna to understand more and avoid putting your foot in it.

About Buenos Aires, Highlights

This week, a few further thoughts on how far dermatology has come in the past two decades and what we supplicants can look forward to at the World Congress of Dermatology in Buenos Aires.

What will the presiding themes be? What (and who) should we go to hear? How has the World Congress evolved over the last decade?

Personal View

While many of us have state-of-the-art facilities and resources at our finger tips, we should not forget the millions who do not have access to pharmaceuticals or specialized medicine, let alone the fundamental nursing infrastructure which is the bed-rock of practical dermatology. Infectious skin diseases are conquered in the first world: they are not in the third. As I prepare for my trip I am constantly reminded of just how fortunate I have been throughout my medical career, and that developing nations need the support of the international medical community now, more than ever.

So how far have we actually come in the past 20 years? Two decades ago as a keen young(ish) general practitioner with the secret desire to be a dermatologist, I simply observed, excised or curetted the various lesions occurring in patients who presented more in hope than expectation. I did not think of skin as a contiguous organ or wonder what biochemical wonders lay beneath the surface. Skins appendages were distained or ignored. Cosmetic products although with an historical mandate, were part of a demi-monde.

I adhered to the old mantra: when it’s dry, wet it and when it’s wet, dry it.
Now, thanks to exposure to the global world of dermatology and the scientists of the cosmetic industry, I think in terms of cytokine cascades, immunological self tolerance and stem cells. One of the most poisonous substance on the planet, botox, has become my therapeutic best friend, but I use it in combination with highly effective and affordable cosmetic products.

Finally, I am humbled by the efforts of those working in the developing world to help people who depend on our support and assistance.

World Congresses

I went to my first World Congress in Sydney in 1977, when we, not surprisingly, reflected on the perils pale peoples face in a light-filled world. Professor Robin Marks, Congress President and now President of the International League of Dermatological Societies (ILDS), was instrumental, amongst others, in highlighting to the wider world the perils of skin cancer. This, in my view, was comparable to the work of Richard Doll and immeasurably raised the profile of dermatology.

I am hopeful that this academic profile can be sustained in the light of relentless governmental pressures to reduce the status of the discipline.

I was privileged to participate in a round table discussion on “The Benefits of Lifetime Photo-Protection” subsequently published in the Royal Society of Medicine International Congress and Symposium series. Did it help? How far have we come since then?
Sadly it continues to amaze me that legions of these pale-skinned individuals inflict deliberate and serious cutaneous damage in a way that would have Health & Safety in apoplexy, were it in the workplace. Photobiology has come a long way since then. Academics, health gurus and industry formulators continue to cry out in anguish as sufferers expect miracle cures for their badly damaged skin.

Some of the leading academics and industry researchers will be showcasing findings next week. Look out for some outstanding presentations and posters. (See below)

At the Paris World Congress in 2002, the buzz was all the new biologicals: how psoriasis would be conquered, and how blistering diseases would be a thing of the past. Little did we realize that the astronomical costs of these treatments would be a difficult burden to bear for health care systems and individual patients. Look out for keynote presentations on where the world now stands in this area. (See below)

We also witnessed major cosmetic companies beginning to rival the pharmaceutical giants in the scope and scale of their satellite symposia. The depth of research being carried out in the R&D centres came as a surprise to many seasoned and cynical onlookers. We began to understand the assiduous application of risk assessment models for potential allergens by collaboration between regulators and industry.
This year, the level of oral presentations and posters on fundamental research into disorders of ageing reaches new heights. Do attend the P&G Satellite symposia and visit the poster hall. (See below)

So - what to look out for/what to do (For full details consult the official program)

• Look through the program and plan your day/week to avoid disappointment
• Be sure to choose lectures/workshops or symposia which meet your needs and interests but also – go to something different
• Choose a lecture that may have no immediate relevance but looks inspirational
• Consider what may be important for your practice over the next five years
• Do take some time out to avoid battle fatigue

I plan to attend the following sessions, which reflect my interests (trichology, cosmetic dermatology, office-based primary care dermatology).

Try and compose your own agenda:

Special lectures, advances and hot-spot sections

• “Quo vadis- A focus on wellness or disease?” – Klaus Wolff, October 3 – as per the road to Damascus?
• Stem cells- dreams and reality – Otmar Wiestler, October 5 – should interest the scientists looking to make a fortune

Symposia

Psoriasis/Eczema

• Psoriasis – Chris Griffiths, October 5 – world authority on difficult and quality of life affecting disease
• Occupational dermatoses – Torkil Menee (chairs top class faculty), October 4 – for those involved in public health affairs

Phlebology

• Phelbology and management of leg ulcers – H. Neumann, October 5 – outstanding speaker on an unglamorous but increasingly important subject which will affect all of us with ageing populations

Skin Ageing/Pigmentation

• Pigmentary disorders – Jean Bolognia (great speaker), October 4 – important topic to the office dermatologist
• Antioxidants – Jean Paul Ortonne, October 4 – world authority on coming area in cosmeceuticals
• UV skin damage, in search of light – Anthony Young, October 5 – world authority, peerless
• Gene expression profiles associated with intrinsic and extrinsic ageing –Robert Binder, October 2 – important ageing research
• Skin of color around the world – Susan Taylor, October 3 – fascinating on-going debate with charismatic faculty
• New insights into skin appearance and measurement – Paul Matts, October 4 – reviews the latest skin measurement technologies, always well worth a listen

Satellite symposia

Cosmetic Dermatology

• The Real Benefits of Cosmetics – Florence Poli, October 3 – chairs faculty on subject increasingly important in daily practice

Hair & Nails

• P&G Sponsored Symposium – Hair & Scalp Science Breakthroughs – Rod Sinclair (chairs world class faculty), October 3 – fundamental science to practical tips for the office physician, Do not miss!
• Breakthrough understanding of dandruff and seborrhoeic dermatitis through whole-genome analysis – Tom Dawson, October 3 – P&G sponsored symposium, outstanding beauty science research presented by a unique speaker.
• Treatment of seborrhoeic dermatitis of the scalp – Jim Schwartz (top scientist), October 4 – P&G Satellite Symposium includes new clinical data on the question of tachyphylaxis
• Nails – Antonella Tosti, October 5 – world class authority and always a hit!
• Trichology – Juan Ferrando, includes David Whiting, October 2 – top dermatopathologist

Events Attended, Highlights, Previous WCDs

This week, a few practical tips for the delegate and his or her entourage, on how to survive the 21st World Congress of Dermatology to be held at the La Rural Convention Center, Buenos Aires September 30th – October 5th.

In order to make the best of such an intellectual and social maelstrom, planning and tenacity are essential. Activities fall into work, official functions and play.

WORK

More details in the coming blogs on which are the talks not to miss but DO go on line NOW to program@dermato2007.org to make sure you work out what you want to see and hear during the week. Planning now can avert disappointment later.

Make sure you put the P&G Beauty Satellite Symposia in your diary, blackberry or iPod.

OFFICIAL FUNCTIONS

See and be seen at the following:

Opening Ceremony (included in the registration fee):

The Opening Ceremony will be held at the Convention Centre, on Sunday, September 30, 2007 at 18.30. Delegates accompanying persons and exhibitors are welcome.

Welcoming Reception (included in the registration fee):

Following the Opening Ceremony, the Welcoming Reception will be held at the Exhibition area of the Convention Centre, on Sunday, September 30, 2007.
Delegates accompanying registered persons and exhibitors are welcome.
Return transfers will be provided by coach.

**A good chance to get stuck into the atmosphere and to arrange to meet with old friends.

Congress Closing Party: Registered delegates and accompanying persons may also participate in what is described as “a unique party” on Thursday, October 4, 2007, from 20.00 to midnight. According to the organisers, “Refreshments, music and dance are scheduled. Wander, relax, be entertained, dance and look out for a few surprises through the night.” – the mind boggles!

Tickets are required; limited attendance. It is advisable to purchase tickets in advance. Fee: US $95

PLAY (SOCIALISING)

One should never underestimate the impact of socialising during these major events.

Getting together in the evening with professional colleagues and friends is often as important as set lectures and workshops. Certainly for the Exhibitors this is a key part of the week.

Never deride the importance of industry at such events; without them, barely any progress would ever happen; without their products or surgical provisions, we could be mere observers of cutaneous disease.

In 20 years, the most obvious change has been the emergence of major cosmetic manufacturers as equals to the traditional pharmaceutical houses. For instance, this year the cosmetic powerhouse that is P&G Beauty will offer a series of symposia bringing some of the world’s experts in the science of skin, hair and cosmeceuticals to the podium. In the exhibition hall, the latest technologies in hair, hair colour and skin care will be displayed – AND for the delegates – those quality products to take home to the loved ones! In the poster hall, scientific quality undreamed of a decade ago will be on display for the inquisitive mind.

The Gala Dinner is a great opportunity for “networking” (apologies to aficionados of the Queen’s English) in a homogeneous atmosphere and for some “surprises throughout the night”.

The President’s Dinner, hosted by P&G Beauty, welcomes leaders of the global, regional and local organisations in their increasingly global quest to promote training, safety and efficacy standards, and in some cases, defend the speciality against cost-containing bureaucrats and professional interlopers.

Having penciled in your week, following are some valuable logistics and recommendations for dining and getting out and about…

BUENOS AIRES: USEFUL TIPS FOR DELEGATES

CLIMATE & DRESS

Spring begins in September and visitors can expect a temperate climate with average temperatures in the afternoon around 22°C (~72°F) with occasional rain, so pack light and you’d be prudent to bring an umbrella.

Comfortable cloths for lectures, sightseeing and shopping but ladies, don’t forget posh-frocks for the Gala Dinner and gentlemen will need to sport or hire a tuxedo if invited to the President’s Dinner, sponsored by P&G Beauty.

Smart casual is de-rigueur if out in the better restaurants.

AIRPORTS

The two runway Ministro Pistarini International Airport is located in the suburb of Ezeiza, about 35 km (40 minutes’ drive) from the centre of Buenos Aires city. It is also the hub of international routes of Aerolíneas Argentinas.

The airport has two terminals: International airlines arrive and depart from Terminal A which can be very busy, so arrive in plenty of time for your flight home.

The Aeroparque Jorge Newbery airport, located in the Palermo neighborhood next to the riverbank, serves mostly domestic traffic.

TRANSPORTATION

Taxis in Buenos Aires are distinguishable by their standard black and yellow exterior. They are available 24 hours a day, either by flagging or reservation. Payment is per meter reading and not by district. Available taxis are marked LIBRE.

Buses or Colectivos
Buenos Aires has a large network of buses, locally called “Colectivos”. There are 144 lines, each identified with a number and different colors. You purchase your ticket on the bus with coins only. Once on board, you must tell the driver your destination and he/she will enter the amount on the ticket machine. The machine prints a receipt as proof of payment and it is advised that you do not discard the receipt until exiting the bus. If you do not have exact fare, wait until the machine gives you change. Most lines operate 24 hours a day, 7 days a week. Late night services are less frequent. At your stop, go towards the back of the bus and ring the bell on top of the back door.

Car Service or Remises
Remises can be secured by telephone or in person at the “Remiserias”. The price of the trip is arranged at the time of reservation. This form of transportation is very safe, cheaper than taxis and will always take the fastest route. The “remiserias” or “agencias de remise” are small offices or store fronts located throughout the city.

Subway
The subway system is very reliable and it covers the city centre and outskirts of the city. There are five lines identified with letters A, B, C, D and E, which undoubtedly provide the fastest way to move around the city. The subway system runs Monday – Friday from 6am to 10pm, Saturdays, Sundays and holidays from 6am to 8pm.

ATTRACTIONS
Luckily for Congress participants, the La Rural Convention Center is in an excellent location, accessible from anywhere in the city. In anticipation of a “balanced” visit I offer some places of interest.

Teatro Colon
One of the world’s finest opera houses, the Teatro Colon is a site not to miss while in Buenos Aires. Located at 9 de Julio Avenue, in the heart of the city and on a site once occupied by Ferrocarril Oeste’s El Parque station, the building has its main entrance on Libertad Street. For show or tour times, please visit http://www.teatrocolon.org.ar/inicio.htm.

La Boca
La Boca embodies the varied architecture of the city’s multinational heritage. With Spanish Colonial design, Italian detailing and graceful French Classicism. Muralists have turned this area of the city into colorful avenues and a delight for tourists.

Plaza de Mayo
The Plaza de Mayo is the city center (the city, in fact, was literally built around it), and some of Argentina’s most important historical events took place here. Surrounding it is the Government House, the Metropolitan Cathedral and the Cabildo (town hall).

…and last but not least:

TANGO

Tango music was born in the suburbs, notably in the houses of ill repute of the Junín y Lavalle district and in the arrabales. Its sensual dance moves were not seen as respectable until adopted by the Parisian high society in the 1920s, and then all over the world. Tango enjoyed a resurgence in global popularity later in the 20th century due almost exclusively to Astor Piazzolla and his development of the tango nuevo style. In San Telmo, Sundays are devoted to tango shows on the streets and antiques trade in the bazaars around Dorrego Square. Tango shows can be found in establishments such as Rivero’s El Viejo Almacén.

DINING

If in doubt, be generous to the Concierge in the hotel to get you prime restaurants as well as shows and tours. Never underestimate the power these powerful allies wield.

The dining options in Buenos Aires are infinite. Argentinean culture emphasizes its multinational cuisine and gathering people to enjoy it. In-line with the social norm, most restaurants do not serve dinner until 9pm. Main courses usually consist of Asado, a barbecue of outstanding quality beef, which not surprisingly is the dominant protein source. Bife de Chorizo (sirloin steak) or Empanadas (meat pies) are excellent and will do absolutely nothing for the waist line. Some of the local red wine is an excellent accompaniment. Also, try the Yerba Mate–the traditional gaucho drink made with herbal tea, which claims to have multiple medicinal and healthful properties (placebo not included). Last but not least, you must try the national deserts: Dulce de Leche, a milk jelly, and Alfajores, Argentine sweets made from Dulce de Leche.

Here are a few options to consider for Argentinean cuisine:

Madrigales
With cross-cultural flare, Madrigales serves a fusion of Mediterranean and Argentine dishes in a serene atmosphere with modern oriental décor.

Address: Av. Callao 181, Buenos Aires C1022, Telephone: 11-4370 8007

Golden Tulip Savoy Hotel, MON-SUN 7:00 am-12:00 am

Cost: Inexpensive

Restaurant Pigalle
This restaurant is a hit with travelers - live local entertainment and a traditional Argentinean menu.

Address: President M. Ortiz 1835, Peatonal de Recoleta, Buenos Aires 1113, Telephone: 11-4311-6676, Etoile Hotel

Cost: Moderate

Tago Mago
Dancers and acrobats wait tables while singers, jugglers, dancers and trapeze artists entertain diners during the evening hours.

Address: R Obligado & J Salguero, Costanera Norte, Buenos Aires, Telephone: 11-4312-7291

Cost: Expensive

To finish this week’s blog here are some useful Web sites

About the Congress: www.dermato2007.org

Information: info@dermato2007.org

Scientific Program:program@dermato2007.org

Abstracts: abstracts@dermato2007.org

Registration: registration@dermato2007.org

Exhibition: exhibition@dermato2007.org

Hotels: travel@dermato2007.org

Scholarships: scholarship@dermato2007.org

Press: press@dermato2007.org

Highlights

Thoughts turn to spring in Buenos Aires and less than a month to go before the start of the great jamboree that will be the World Congress of Dermatology. The citizens of this proud and independent city, the Porteños, will welcome an anticipated 12,000 delegates on the 30th of September for the 21st edition of this celebration of skin, its appendages, and its disorders. Over five days, the cream of academia, pharmaceutical experts and cosmetic scientists will forgather in the 91,000 square meters of the La Rural Convention and Exhibition Center situated in the Palermo neighborhood, close to downtown Buenos Aires. Lectures, workshops and symposia on every conceivable aspect of this, the largest and most visible organ of the human body, will vie with the technical exhibition where all major pharmaceutical and cosmetic manufacturers have the opportunity to display and give away their wares.

A Personal View

So why am I excited and why might you want to go?
A variety of reasons – some facile and some important.

• Learn some really important “stuff” from the world’s experts
• Meet old friends and acquire some new ones
• Acquire those CME points
• Experience a fascinating vibrant society with unquenchable night life
• Bring lots of presents for the folks at home

World Congresses tend to be like the Olympics – you can see all of the elements in other places but not all together and not with such enervating excitement that you go away feeling like YOU can take on the world.

As with any Congress, location is important – Buenos Aires certainly fits the bill, although I am not sure my new total knee replacement will quite cope with the Tango.

So is the energy of the organisers and the type of people who will be there. Under the guidance of Congress President Galimberti and Congress Secretary Adrian Pierini, the event will definitely be highly exciting – an element too often lacking when trying to refresh flagging skills, learning new ones and merely survive the five days.

Seriously, the bottom line is this – Why is dermatology important? Why do you need a World Congress, and why do YOU need to be there?

Personally, as a physician trained at time when the art of observation, communication and practical management were keystones – dermatology has it all! It is a specialty in which the physician “sees” the problem and the patient can rewardingly “see” rapid benefits from your intervention. At this World Congress, the role of skin in defining our health, wealth, age and identity comes under as much scrutiny as the traditional diseases have over the previous 20 years.

As a 20-year vicarious observer of “global” dermatology – it is manifestly clear that doctors are facing the stark reality of social, governmental and consumer pressure which may affect and change their professional life.

In many developing countries whilst the “old diseases” linger, the cutaneous manifestations of HIV/AIDS represent a major medical and social challenge. The expansion of dermatology services is vital to these societies.

On the other hand, socialised medicine in Europe is pressuring dermatology services to be more cost effective, potentially at the expense of patient specialist care. Other specialities and alternative practitioners are intruding into what was once purely a professional dermatological domain. At the same time, academic dermatologists reluctantly have to face up to a world in which dealing with the “well” patient’s desire to preserve youth will have to be a core function. Already the burgeoning public demand for cosmetic procedures in the USA and other highly developed systems has produced the specialist “cosmetic dermatologist.” Here, association with the cosmetic scientist presents opportunities for development and public service.

Ultimately, it is in the fight against the tide of global skin cancer and by extension, the place of derm-surgery, that the profession has a critical role to play.

Enough of the diatribe…

So, what does a “World Congress” offer? In fact, this 21st World Congress of Dermatology offers something for everybody – the best speakers, the most important topics in disease management, and the best training for this and the generation to come. More importantly, it gives us and physicians dealing directly with patients the opportunity to meet old and hopefully new colleagues, exchange ideas and make new contacts.

SO – if you are already going – see you there!
Don’t forget to visit the P&G Beauty stand and DO attend the P&G Sponsored Symposia (links below).

If you have nothing better to do in the first week of October – could do worse than a week in the sun in vibrant Buenos Aires.

THINGS NOT TO MISS:

Opening Day, Monday, October 1, 2007

• Workshop: “Genomics and proteomics: a link to practical dermatology,” Giovanna Zambruno (Italy), Nelida Davalos (Paraguay), Junh-Mo Yang (Korea) and Ervin Epstein (United States) – 8:15 to 10:15.
• Symposium: “Ethnic hair and skin physiology,” Victoria Holloway (United States), Xue Min Wang (China), Sergio Talarico (Brazil), Adama Traore (Burkina Faso – 8:30 to 10:30.
• Symposium: “UVA and the skin,” Andre Rougier (France), Franklin Madero (Ecuador), Yoon Kee Park (Korea), Irene Stefanaki (Greece) – 8:30 to 10:30.

Day Two, Tuesday, October 2, 2007

• Workshop: “Photoprotection and Sunscreens,” John Hawk (United Kingdom), Zhigang Bi (China), Alejandro Ruiz Lascano (Argentina), Peter Wolf (Austria) – 8:15 to 10:15.
• Plenary: “Toll-Like Receptors: Role in Skin Inflammation,” Philippe Musette (France) – 11:34 to 11:54.
• Workshop: “Understanding and Governing Cell Migration,” Bernhard Homey (Germany), Jorge Laffargue (Argentina), Jean Francois Nicolas (France), Wolfgang Weninger (United States) – 13:45 to 15:45.

Day Three, Wednesday, October 3, 2007

• Sponsored Symposium: P&G Beauty “Hair and Scalp Science Breakthroughs,” Prof. Rodney Sinclair (Australia), Amy McMichael (United States), Ramon Grimalt (Spain), Tom Dawson (United States), Prof. Ralf Paus (Germany), Prof. Antonella Tosti (Italy) – 14.00 – 16.00, Room B
• Workshop: “Skin Barrier: Mechanism and Repair,” Enzo Berardesca (Italy), Peter Elias (United States), Genji Imokawa (Japan), Cristina Pascutto (Argentina) – 8:15 to 10:15.
• Workshop: “Skin of Color Around the World,” Susan Taylor (United States), Martha Minino (Dominican Republic), Jean-Jacques Morand (France), Edith Nkechi Nnoruka (Nigeria) – 13:45 to 15:45.
• The real benefits of cosmetics – Prof. Zoe Diana Draelos (United States), 14:00 – 16:00
• Alopecia Areata – Prof. Jerry Shapiro (Canada), 13:45 – 15:45

Day Four, Thursday, October 4, 2007

• Sponsored Symposium: P&G Beauty “Skin Health and Anti-Aging Research Update,” Alexa Boer Kimball (Chair, United States), Paul Matts (United Kingdom), Jean-Paul Ortonne (France), Kevin D. Cooper (United States), Wenyuan Zhu (China), Zoe Diana Draelos (United States) – 8.45 to 10.45, Room B
• Satellite Symposia: P&G Beauty “Cosmeceuticals: Practical Solutions for Common Problems,” Zoe Diana Draelos, MD (Chair, United States), Steven Shiel (United Kingdom), James R. Schwartz (United States), J Frank Nash (United States), Patricia Engasser (United States), Harald Schlatter, PhD (Germany) – 16:30 to 18:30, Room D
• Workshop: “Antioxidants and the skin,” Unandar Budimulia (Indonesia), Graciela Cuomo (Argentina), Sheldon Pinnell (United States) – 8:15 to 10:15
• Antioxidants – their efficacy in dermatology – Prof J.P. Ortonne October 4th 13:15- 14:15

Day Five Friday, 5th October 2007

• Nails – Prof Antonella Tosti – October 5th 14:00 – 16:00
• Hair diseases – Prof Blume – Petayvi and Professor David Whiting , October 5th 8:30 – 10:30

Buenos Aires conference, dermatology conference, Highlights, La Rural Convention and Exhibition Center, World Congress of Dermatology