Forum for Nordic Dermato-Venereology No 3, 2019 Telemedicine | Page 23

Dermato-Venereology in the Nordic Countries
Hudläkarforum Q and A
C arsten S auer M ikkelsen 1 , J ohn P aoli 2,3 , S am P olesie 2,3
and J an E klind 4
Research Lab, Department of Dermatology, University of Aal-
borg, and Private Dermatology Practice, Brønderslev, Denmark,
2
Department of Dermatology and Venereology, Institute of Clin-
ical Sciences, Sahlgrenska Academy, University of Gothenburg,
3
Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg and
4
Diagnostisk Centrum, Apelbergsgatan 60, SE-111 37 Stockholm, Sweden. E-mail address: [e-mail]
1
The purpose of this article written in an interview form is to
highlight the importance of the Facebook group Hudläkar-
forum, and show the possibility of sharing educational cases
via the Internet with other Nordic dermatologist colleagues
ensuring high quality diagnosis and treatment in an academic
environment.
Questions are answered by Jan Eklind who is the founder and
main moderator of the Facebook group Hudläkarforum and
by John Paoli and Sam Polesie as frequent users of the site.
function so you can search for a diagnosis for example. Some-
times colleagues ask if they can use cases for real-life education
and my answer is usually yes – if it is my case.
How does the site work?
You apply for membership on Facebook and need to answer
a few questions about your experience (specialist or resident
in dermatology) and where you work. There are simple rules.
You must never compromise the patient’s identity, so no full-
face images or patient data are allowed. The forum is also for
dermatologists only.
Q uestions
and
A nswers – J an E klind :
Why did you get the idea of developing the Facebook group Hud-
läkarforum?
I work mainly in private practice and that often means working
alone, especially if you work in a small clinic where there is
nobody to share or discuss difficult or just fun cases with. I
started saving my dermoscopy pictures of all pigmented lesions
I excised and looked at them again when the pathology reports
came to get feedback. I have been on numerous dermoscopy
courses and, especially when something seemed odd or when
I noticed discrepancies, I needed someone to discuss my cases
with. I often met John Paoli at the AAD meetings, which I try
to attend every year. I asked John if I could discuss such cases
with him via email. He accepted and so we did. I came up with
the idea of Hudläkarforum mainly to share such challenging
cases online to share our knowledge.
When did you open the site? How many users and cases are there?
I started it as a closed Facebook group in July 2016 and added
all my dermatology colleagues and friends. Since 2005, I have
been working part-time in Norway on and off, so I also added
my Norwegian colleagues. As of today there are 250 members.
Most members are Swedish and Norwegian but there are also
members from Denmark and Iceland. I am not sure how many
cases there are in total but last month 35 cases or posts were
added with 199 comments and 325 likes. There is a search
Forum for Nord Derm Ven 2019, Vol. 24, No. 3
Is Hudläkarforum only used for cases or other purposes as well?
I usually post when I hear interesting news or get information
about a drug that we prescribe which is suddenly unavailable.
I e-mail the companies and try to get info when it will be
available again.
It is also fun to post discussions about clinical scenarios and
ask what users would do in such a case? This makes people
think, I hope! For example, how would you treat a relative?
How would you treat yourself? We treat differently from what
we have experienced through our years in practice and local
traditions. I also try to be as efficient as possible during patient
care and try to minimize the numbers of visits. Sharing tips
and tricks is fun. I might share too many things and cases,
but it seems that members like them.
We have also discussed matters on which margins you should
use if you have a clear clinical suspicion thanks to dermo­
scopy. If you are sure it is a melanoma in situ, we have all
agreed that you can excise it with 5 mm margins and then
do not need to re-excise afterwards. Another discussion we
had was on how to treat severe dysplastic naevus where a
lot of pathologists write in their pathology report that they
suggest using even wider margins despite the lesion being
completely removed, which is unnecessary according to our
national guidelines.
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