Dear Editor,

Scientific congresses and conferences are held to present the latest specialized scientific achievements. Thematic analysis of the content presented at these congresses somewhat reflects the trends of scientific progress in a specific field according to the needs and facilities. Dermatology includes extensive specialized branches such as immunology, oncology, surgery, pathology, and aesthetics. According to the studies presented at the International Investigative Dermatology meetings held from 2010 to 2019, a broad range of topics have been explored, and the diversity of submissions has risen ¹ . The content analysis of the largest dermatologic conference in Germany (3,100 presentations) underlined the importance of the “patient” and “therapy,” which were the most used words according to the common network analysis parameters ² . On the other hand, most of the patients referred to dermatologists have aesthetic problems and are not content with their appearance. The desire for beauty and youthfulness is rising worldwide and is most relevant to dermatologists ³ . The increasing demand of patients to improve their appearance through specialized services of dermatologists has significantly affected the trends of dermatological procedures since 2001 ⁴ ; the highest increase was seen in soft tissue augmentation (4 times), botulinum injections (3 times), and similar interventions ⁵ . The growth and popularity of aesthetic procedures increased scientific reports and research in this regard. Of course, this has influenced the congresses and conferences specialized in dermatology and has strengthened the belief that the education and research of specialists are more inclined toward aesthetics.

In Iran, from 2001 to 2019 (before the COVID-19 pandemic), about 20 national and international congresses and conferences were held. Considering the growth of patients' aesthetic demands and dermatologists' role in improving appearance, we reviewed the topic presented in scientific congresses and conferences to determine the research trends and explore whether aesthetics is dominant or medical topics.

In this descriptive cross-sectional study, the congresses were selected through an easy sampling method. Our sample included presentations at 20 national and international dermatology congresses held in Iran from 2001 to 2019. Two dermatologists assessed all presentations and classified them by discussion and mutual agreement into two topics: medicine and aesthetics. Other recorded variables were location, organization of providers, and the year held. Data were described and analyzed using SPSS 23. This research project (No. 96000256) was approved by the Ethics Committee of Kerman University of Medical Sciences (IR.KMU.AH.REC.1399.116).

Most of the 1,424 presentations were held in Tehran (90%) by the Tehran University of Medical Sciences (73.5%) and the Iranian Association of Dermatologists (11%), followed by Shahid Beheshti and Isfahan University of Medical Sciences (Table 1). A significant difference was found between the organizations in terms of the presentation topics (X²=23.8, df=3, P<0.001).

Only 106 (7.4%) presentations were in the field of aesthetics, while most (92.6%) covered medical topics (Table 1). The distribution of topics was significantly different according to the year of the presentation (X²=51.4, df=13, P<0.001). The topics of presentations every five years are shown in Figure 1. From 2001 to 2005, the number of medical presentations was 137, while the aesthetic ones were 5. The corresponding numbers from 2011 to 2015 were 156 vs. 22. The aesthetic-to-medical topics ratio increased from 0.04 in 2001-2005 to 0.09 in 2016-2019.

Figure 1. The thematic relation of medical and aesthetic presentation. The ratio of aesthetic-to-medical presentations at major dermatology congresses in Iran increased from 2001 to 2020.

Dermatology is a broad medical field with numerous subfields. This study traced 1,424 presentations at 20 congresses held from 2001 to 2019. The Annual Congress of the Iranian Association of Dermatologists was the most recurrent (2001, 2008, 2013, 2016, 2017, 2018, 2019). Five of the conferences were not repeated and were held only once. Most of the presentations were at congresses held in Tehran by the Tehran University of Medical Sciences (1,047 presentations), followed by the Iranian Association of Dermatologists (156 presentations). Investigating the dermatology publications from Iran showed that the Tehran University of Medical Sciences, followed by the Shiraz University of Medical Sciences and Isfahan University of Medical Sciences, published the most articles ⁶ . Men had the most presentations. However, no relation was found between topic groups and sex or type of presentation. In contrast, Guo and Nambudiri found small sex differences in dermatology according to the research output ⁷ . People’s desire to increase their beauty and hide their aging is rising worldwide ³ . Although we found that 92.6% of the presentations were on medical subjects and only 7.4% were on aesthetics, the aesthetics-to-medical presentations ratio has more than doubled in recent decades (Figure 1). This tendency toward cosmetic dermatology was reflected in a survey conducted in Iran, where about one-third of dermatology residents declared their preference of cosmetic procedures over medical dermatology ⁸ . The aesthetics-to-medical presentations ratio also depended on the hosting organization. This was such that the Iranian Association of Dermatologists hosted almost a quarter of all aesthetics research presentations. Recent studies paid more attention to the distribution of medical topics in dermatological research rather than its relation to cosmetics. The comparison of topics with DALY publications in 2018 showed that on PubMed, “psoriasis” followed by “acne” and “alopecia” were over-represented ⁹ . In line with the global trend, Iranian dermatologists also appear to prefer medical dermatology and spend less than 10% of their time on cosmetic procedures ⁸ .

Our study was limited to presentations of the most important congress in the dermatology field and did not include all research types (theses, papers, etc.). We recommend a global study of all publications. Also, medical interventions should be compared with aesthetic interventions to understand better the direction toward which dermatology is moving.

In conclusion, medical research still dominates aesthetic research in Iran. However, in line with the global trend, aesthetic research in Iran is on the rise since the ratio of medical presentations to aesthetic ones is decreasing, with the hosting organization also influential on the presentation topic.

Acknowledgment

None.

Authors' contributions

Maryam Okhovati programmed the project, helped in writhing manuscript

Manzumeh Shamsi Meymandi analyzed the data, written the manuscript

Simin Shamsi Meymandi Performed the Idea and edited the manuscript

Sajad Saljoghian collected the data

Funding Source

There was no funding for this study.

Conflict of interest

None declared.

References

1. Bauerdorf F, Kaczmarczyk R, Zink A, et al. Trends and perspectives for dermatological research in europe: an abstract title analysis of ESDR and IID congresses 2010–2019. J Invest Dermatol. 2020; 140(9):S197-S200.
2. Kaczmarczyk R, King F, Biedermann T, et al. What’s driving dermatology? Contribution title analysis of the largest German Dermatology Congress 2019. Digital Health. 2021; 7:20552076211012138.
3. Steinkraus V. Aesthetic dermatology. Z Arztl Fortbild Qualitatssich. 2006;100(9-10):650-2; discussion 8, 724.
4. Tierney EP, Hanke CW. Recent trends in cosmetic and surgical procedure volumes in dermatologic surgery. Dermatol Surg. 2009; 35(9):1324-33.
5. Ibrahim O, Berson DS, Rohrer TE. Trends in dermatologic surgery: results of the American society for dermatologic surgery procedure and consumer surveys. Dermatol Surg. 2019; 45(2):303-6.
6. Makkizadeh F, Bigdeloo E, Taherizadeh A. Tracing the scientific outputs of lranian papers on dermatology research based on publications in the Web of Science. Collaboration–Impact on Productivity and Innovation: Proceedings of 14th International Conference on Webometrics, Informetrics and Scientometrics &amp; 19th COLLNET Meeting 2018, December 5-8, 2018, University of Macau, Macau; 2018.
7. Guo LN, Nambudiri VE. Small sex differences exist in dermatology resident research output: A cross-sectional analysis of scholarly publishing during dermatology residency. J Am Acad Dermatol. 2021; 84(1):216-8.
8. Kiafar B, Nahidi Y, Morovatdar N, et al. A national survey: desire of dermatology residents to train in cosmetic dermatology and its association with learning medical dermatology. Acta Medica Iranica. 2018; 56 (9):591-7.
9. Kaczmarczyk R, King F, Tizek L, et al. Visualising the past to plan the future: a network analysis of the largest European dermatology conference. Eur J Dermatol. 2021; 31(2):161-9.