Forum for Nordic Dermato-Venereology Nr 1, 2018 | Page 9

Elisabet Nylander – Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University and University
Hospital, Umeå, Sweden
persons. Our research into the impact of hyperhidrosis on
quality of life has shown that the disease mainly affects
psychological health, but the effect seems to diminish soon
after treatment.
Patients with axillary hyperhidrosis are those with the most
effect on their health, while those with hyperhidrosis in other
areas seem to be less affected.
Digital health
Our department has many years’ experience delivering clin-
ical teledermatology services: videoconferencing and store-
and-forward. We are now investigating the potential role of
new modes of service delivery within the healthcare system,
focusing on dermatology.
An ongoing research project is into using robotic telepresence
for leadership and consultation in a dermatology department.
The skills and experience of a senior consultant and head
are difficult to replace. When the opportunity arose for the
chief physician in our unit to work abroad (in Australia), she
arranged to be “present” digitally, in order to continue work
in her unit in Umeå.
In order to understand how technology affects users and
organizations, we are conducting a user study based on
methodologies from human–computer interaction. We will
also explore the implications for patients, in terms of trust
towards the telepresent clinician and how the patients’ ex-
perience the power relationship. This experience has already
pinpointed valuable challenges, improvements and strategies
for remote working.
Environmental health
Our department participates in research organized by the
Swedish Contact Dermatitis Research Group into occupational
dermatoses and environmental exposure, with a focus on aller-
gic contact dermatitis. Revisions of test panels for patch testing
in Sweden are based on published results from the group.
Building-related illness (BRI) is common in the Swedish pop-
ulation. According to Folkhälsomyndighetens Miljöhälsorap-
port (2017) 20% of the Swedish population report symptoms
that they attribute to the indoor environment in their resi-
dence, school or workplace. The mechanisms behind BRI are
unknown, but a number of risk factors have been determined,
such as low rates of ventilation, psychosocial factors, e.g. stress,
Forum for Nord Derm Ven 2018, Vol. 23, No. 1
frequency of cleaning and exposure to a number of emission
sources, such as mould and moisture-da maged building ma-
terial. We have long experience of studies utilizing epidemio-
logical methods and, in a present study, questionnaires have
been combined with advanced measurements of exposure to
chemical compounds and particles, tools used to monitor psy-
chosocial factors, measurements of skin sensitivity (capsaicin
test) and blood samples from participants. We expect to find
chemical compounds or chemical patterns associated with BRI.
We also expect to gain an understanding of the mechanism
involved in BRI. A new project is currently being initiated to
explore the role of transient receptor potential (TRP) channels
in the pathogenesis of building-related symptoms.
The department is also involved in a regional project in the
northern part of the Nordic countries concerning energy effi-
cient renovation of buildings. Our contribution is a literature
compilation of the health effects of renovation. There are
several studies reporting beneficial effects, but there are also
reports of increased risks of developing several diseases, e.g.
atopic dermatitis among children.
An ongoing PhD project aims to develop a specific quality
of life instrument for cutaneous leishmaniasis in Iran. Based
on qualitative interviews with Iranian patients a tentative
questionnaire has been tested in an Iranian out-patient popu-
lation. The results have been analysed using classical statistics
and Rasch analysis, with the goal of developing a 10–15-item
instrument with good psychometric properties.
Our main contribution
• A focus on STI and vulvar diseases, which is a relatively
uncommon area of research in Sweden.
• Projects on inflammatory diseases, in which all participants
have their own specialized role.
• A focus on indoor air.
• Research into hyperhidrosis, which is, in many respects, an
unexplored disease.
• Research into e-health, which is a rapidly expanding field.
Our strenghts
• We perform a combination of qualitative, quantitative and
molecular research.
• Our multidisciplinary approach to projects.
• Our close connection to the clinical implications of all our
research.
D ermato -V enereology in the N ordic C ountries
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