We at Diagnostiskt Centrum Hud are very proud of our combined expertise and we actively support research and development in our business.
Since inception, we have integrated research and development into our operations. We want to be a good example among private healthcare providers and care choice clinics and show that research and development can be conducted even outside university hospitals. With the ongoing exodus of dermatology from hospitals to specialist clinics closer to the citizens, it is also natural that this is where the research is conducted. We have run several projects over the years, but by far the biggest is our ongoing VINNOVA-funded investment in Artificial Intelligence, AI. See more below.
Our first research projects were carried out in spring 2013. There were interviews and survey studies of our patients who applied for suspected skin tumor about their anxiety, sun habits and skin tone ideals. Questions were also asked as to whether or not they had delayed seeking treatment, and it then emerged that some of the older men in particular had delayed applying as they thought that skin changes were too banal to seek medical attention for. Studies on sun habits and skin tone ideals have shown that the majority of young people in Sweden with naturally pale skin strive for a clear "tan". The results have been highlighted in the Annual Report of the Swedish Radiation Safety Authority's UV Council.
In later projects, in collaboration with Karolinska Institutet, we have studied our ability to effectively find malignant melanoma among all those who come to us with symptoms. We were able to exhibit short lead times and the results were published in a scientific article.
In total, eight medical students have successfully completed their semester-long degree projects with us. Responsible for the studies and the students are oncologist and co-founder Magnus Bäcklund together with Professor Yvonne Brandberg.
Petra Kjellman is one of the Clinic Directors, and sits on the company's Board of Directors.
She combined internships at Karolinska University Hospital in Solna with research, and became a licensed doctor, receiving her PhD in 2004.
She became a dermatology specialist at Karolinska University Hospital in Solna in 2009. She specialised in skin tumors and completed training at the Clinic for Reconstructive Plastic Surgery at Karolinska University Hospital. Here's a selection of her research:
Having previously served at the skin clinic at Karolinska University Hospital and as a consultant in the dermatology clinic at Södersjukhuset, Cristina is a general dermatologist. She has also defended her PhD in acne, and antibiotic resistance in antibiotic-treated acne sufferers. Cristina is a member of the Global Alliance to Improve Outcomes in Acne, an international group of dermatologists and researchers. The Global Alliance publishes research overviews and new treatment recommendations for acne. Here is a selection of her research articles:
Dermatologist – Dermatology Specialist
Malignant melanoma is the most serious form of skin cancer. Malignant melanoma occurs in the skin's pigment-producing cells, the melanocytes. When exposed to UV light, the production of pigments is stimulated and we become tanned. This makes the skin better able to withstand exposure to the sun's rays. If the genome of a melanocyte is damaged due to UV radiation, the melanocyte may gradually change and begin to divide uninhibitedly to form a malignant melanoma. This can take time, as from the onset of an injury in the genome of a melanocyte, it can be decades until a malignant melanoma develops.
Malignant melanoma in the skin is most often detected when the patient themselves, or someone in their surroundings, notices a new or altered mole. About half of all skin melomas occur in previously healthy skin and half in existing 'liver spots' or 'moles' (these are the same thing). The diagnosis of malignant melanoma is made by removing the suspected skin change and then analysing under a microscope. Malignant melanomas should be removed with the margin (healthy tissue) around them and surgery is usually a curative measure.
Malignant melanoma is the fastest growing type of cancer. Every year, more than 4,000 Swedes suffer from malignant melanoma and 500 die from the disease, which is more than in road traffic accidents. Read more about malignant melanoma at the Cancer Foundation.
The other skin tumor types, squamous cell carcinoma and basal cell carcinoma, are derived, as their names suggest, from other cell types in the skin. They are much more common than melanoma but do not get the same attention as fortunately they have very low mortality rates. However, these types of tumor can occur repeatedly and in new places. Also, the treatments can cause discolouring scars, for example, on the face, as even these tumors are mainly caused by the sun.
Squamous cell carcinoma and basal cell carcinomas are mainly located in areas exposed to the sun and usually appear as small bumps in the skin or wounds that do not heal for a couple of months. The tumors are treated many times directly because they have a typical appearance for the habitual eye, but sometimes if the diagnosis is uncertain, a sample is taken to ensure proper diagnosis. Treatment may include surgery, freezing, photodynamic treatment (PDT), various cytostatic creams or a combination of these.
Acne affects nearly 4 out of 5 adolescents, most of whom have mild symptoms but about 20% of whom get severe acne. Acne is due to a genetic sensitivity in the sebaceous glands of the skin that causes these to react excessively to our usual hormone fluctuations. Even mild acne can be very difficult in some people and cause them to feel ashamed and to withdraw from others. It can lead to impaired self-confidence and increase the risk of depression. Adults with acne, especially women, are a group that is increasing in number. The factors that cause acne in adults are approximately the same as in teenagers and the experience of social stigma is also the same.
We therefore think it's important that all patients who have acne symptoms are taken seriously, and our doctors are very knowledgeable and interested in the treatment of all acne patients.
The incidence of Rosacea is increasing and the condition is more common in women than in men. In the most common form, papulopustuless rosacea, acne-like rashes are often found on the nose and cheeks, but can also appear on the forehead and chin. Sometimes a number of ruptured blood vessels (telangiektasias) appear on the nose and cheeks. Another variant, erythematous rosacea, gives a more widespread, almost constant redness of the face. The cause is a genetic propensity but different factors play a role in triggering or worsening rosacea. The most common factors are sun, stress, alcohol and heat, amongst others that cause the vessels on the face to widen and the skin to turn red.
In the condition perioral dermatitis, related to rosacea, there are small rashes around the chin and mouth, which often itch or sting. These are also sometimes on the nostrils or around the eyes. This condition is strongly linked to stress but even excessive facial care can also lead to imbalance and perioral dermatitis.
We have a great track record of treating rosacea and perioral dermatitis with both local treatment (creams) and various forms of tablets, and the treatments are adapted individually.
2-3% of the population has psoriasis. In psoriasis, red well-defined raised patches are usually seen, sometimes with whitish peeling. The patches can appear anywhere on the body but common places include elbows, knees and on the scalp. They usually do not itch too much, though there are exceptions. Most people only have a few spots that come and go but a small minority have large parts of the skin covered with psoriasis. Hands, feet and nails can also be affected. Joint problems (psoriatic arthritis) affect 20-40% of those with psoriasis. The reasons for having psoriasis are genetic and if you have family members with psoriasis you have an increased risk of suffering with it yourself. It can occur at any time in your life.
A lot has happened in the field of treatment over the last 10 years, and we have vast experience of all methods, including the latest systemic treatments, see 'Treatments' below.
The word eczema really only denotes a reaction pattern in the skin with dry, red, itchy rashes. There are different kinds of eczema. The most common is atopic dermatitis which is seen in 1 in 5 children. This eczema usually occurs where the skin flexes, such as inside the elbows, and the backs of the knees, but also on the face and neck, and can actually be found anywhere. The cause is a genetic fragility in the skin barrier that means that it is not as good at maintaining the right humidity in the skin. This then becomes dehydrated and brittle, and inflammation and an itchy rash can be triggered. It is therefore important to lubricate the skin with moisturizer regularly to counteract dehydration, but if eczema has occurred, treatment is needed that suppresses inflammation. The most common treatment is cortisone cream. Properly used, cortisone cream is effective and well-proven medication without serious risks. In many people, the symptoms of eczema go away when reaching school age, but for a smaller proportion, the worries become lifelong. You also have an increased risk of developing hand eczema if you have had atopic eczema.
Another common type of eczema is seborrheic dermatitis, which give rise to a rash between eyebrows and at nostrils. The reason here is a (genetic) sensitivity to the yeasts that exist on the skin.
Regardless of the type of eczema, we have great combined skills and expertise in treatment with everything from creams to tablets, and, for the most difficult cases, sprays.
We deal with all common skin conditions such as acne, rosacea, different types of eczema and psoriasis, but also assess and investigate different types of skin rashes. If we suspect a contact allergy, we test for it using the so-called epicutaneous test (patch test). We are Stockholm's largest skin clinic outside of hospitals. All our doctors have vast experience - many have been active at university clinics and several also have PhDs. In rare or difficult-to-assess conditions, the specialist doctors consult one another regarding the patient, which increases our competence.
If you notice that a mole has changed color, shape or size, you should have it checked (as most people know). As such, it's important that you can get a specialist assessment quickly - partly to avoid being worried, and partly because if it turns out to be skin cancer, it's important to have it removed as quickly as possible. This means you are likely to have a very good chance of a complete recovery.
At our spot clinic, fast times for assessment and, if necessary, surgery are offered. Fortunately, it's usually not cancer, but you don't know until you have had the change examined.
We treat a large number of patients with acne every year and are experienced and keep updated on the latest in acne treatment. We treat both young people and those with 'adult acne'. Acne symptoms can vary from person to person and can cause great suffering for some people. We therefore attach great importance to adapting the treatment to the patient. We are happy to treat with isotretinoin when needed, especially if there is a risk of scarring, or if the symptoms do not respond to other treatment. For example, longer-term low-dose treatment with isotretinoin may have a good effect in recurring adult acne.
The first choice for both eczema and psoriasis is cortisone cream. However, some patients find their rashes do not clear up, even if they use strong cortisone cream, and too much cortisone shouldn't be used as it can result in side effects e.g. thinning of the skin.
Over the past 10 years, a lot has happened in the field of psoriasis research, with new types of treatments mainly adminstered subdermally. Many of our specialist doctors have been involved with this research from the beginning, and we have now accumulated a lot of experience in treatment with these drugs, primarily for those with moderate to severe psoriasis.
Recently two new drugs have come to market to treat moderate to severe atopic eczema which is heartening. We have several patients who have been successfully treated with these to finally be able to have less irritated skin with reduced itching and decreased eczema.
Unfortunately, all the treatments described above are not cures. Just like with other treatments, it is temporary symptom relief, i.e. if the treatment is stopped, the symptoms often come back. However, for those who have not previously seen any improvements with cortisone creams or taking pills, this development is revolutionary.
Many times it turns out that the changed areas of your skin that you wanted to have checked are not actually dangerous, and there are no medical reasons to remove them. Some people still want to remove them because they think they're unappealing or impractical. We offer removal of these benign areas and we care about a pleasing cosmetic result, but the treatment has a fee.
In cases where a changed skin area is suspected to be malignant, we will ensure that it is removed as a matter of urgency. We operate on such areas on the body and on the face and all our operations are carried out by experienced surgeons. We send all samples for analysis to ensure proper diagnosis.
Derm Summit is an annual scientific symposium arranged by Diagnostiskt Centrum Hud. The meeting is aimed at those who are active in dermatology as well as aspiring dermatologists. For the fourth year in a row, we are presenting an exciting program that covers different areas in the field of dermatology. We look forward to welcoming nearly 150 participants this year.
We are very keen to pass on our knowledge and education in dermatology. We annually award two scholarships of SEK 25,000 each to young, promising dermatologists to enable further research and training at their clinics.
We have an ongoing collaboration with engineers at the Royal Institute of Technology, KTH, in Stockholm to develop AI driven decision support for skin cancer diagnosis. Our project uses a large number of images taken by dermatologists using a smartphone with a connected dermatoscope. Using deep learning AI technology and software developed in the project, the pigment changes that show an increased risk of being malignant can be detected. The technology should not replace dermatologists, but in the future it could provide decision support, mainly in primary care, with the ultimate goal of reducing the mortality rate from malignant melanoma.
The project is financed by ourselves and by VINNOVA.