An Interview with Wroclaw Medical University’s Jacek Szepietowski

Samantha Warne
Editor, European Medical Journal

This interview took place at the 26th European Academy of Dermatology and Venereology Congress on 16th September 2017. Jacek C. Szepietowski is a member of the Editorial Board of EMJ Dermatology 5.1 and kindly agreed to meet and share his thoughts on the congress.

This interview has been condensed and edited for the purposes of length and clarity.

Q: The programme for this year’s EADV congress is huge. When preparing to visit, how do you decide what sessions to attend?

A: That is an interesting question because nowadays the EADV congress has very different roles. Of course, for dermatologists it is the main educational event, but for some of us it is also a place to discuss different ongoing dermatological issues at a European level. For example, for me, I am a board member of EADV, so definitely on one of the congress days we will run a board meeting and make crucial decisions for the future of the academy and the annual meeting.

Nowadays, there are plenty of meetings organised during the EADV congress, including board meetings of different sister societies, such as the European Society for Dermatology and Psychiatry. We are working with the taskforce of EADV to provide a psychodermatology taskforce that is involved in both associations and we are also working on guidelines. I think guidelines are particularly important for clinicians. This year, I am involved in the production of guidelines on the treatment and management of atopic dermatitis; we are planning to have the final meeting here and hopefully these guidelines will be published next year. So, we are moving from meeting to meeting and if you want to participate in these events as well as the congress sessions, you must be well prepared when coming to EADV.

Of course, there are several parallel sessions and you should select the sessions in advance to pick those most interesting to you. I would suggest itch because I have worked in the field of pruritus for >25 years, and the second field would be psychodermatology. We also have a group interest in hidradenitis suppurativa, although these are just my main interests for the meeting and I always look for the workshops and expert sessions to gain a deeper knowledge. We are also speakers; this year I chaired the session on pruritus and I delivered a talk on metabolic itch, a systemic itch occurring in patients with metabolic disorders without skin lesions.

Q: Are there any sessions that you think will have an especially large impact on the field of dermatology?

A: Definitely, there are such sessions organised by both the scientific organising committee of EADV and by the pharmaceutical industry. I think it is a good idea to have this combination of organisers because the pharmaceutical industry brings news of the development of new treatment modalities, and I would especially like to underline the developments made to psoriasis and atopic dermatitis treatments.

Nowadays, there has been a huge development in psoriasis treatment, including the development of biologicals and small molecules. For many years we had no development in atopic dermatitis treatment, and I am so glad to see that many companies are now working on different compounds to control this terrible, bothersome disease, which is present in both paediatric and adult populations.

After this meeting, we may have a hope that something will dramatically change in the management of atopic dermatitis. For example, there are drugs in development that are proposed to be systematically administered but, also, we have some new topical treatments that are specific to dermatology because skin lesions are able to be reached by topical agents.

Q: The level of collaboration at the EADV congress is unparalleled. What are the benefits of having dermatologists from all over the world attending the same event?

A: This year we are celebrating the 30th birthday of the EADV. Thirty years ago, 21 people met and decided to create the society; nobody expected such a huge growth, so I think the EADV is a great success. For many years the focus was on the American conferences, but looking at the programme of EADV and having experience in both events in the USA and Europe, I am sure that nowadays EADV is a very good meeting. The EADV congress is growing, not only in the number of participants, but also in quality. Having colleagues coming from different countries is so nice because it makes it possible to exchange ideas and treatment that are being used locally, which is beneficial.

EADV is a European meeting but nowadays so many colleagues are coming from outside of Europe. Would you imagine that this year there were 700 participants from India? I was really surprised by that number but it means many people are coming to learn at the congress, again underlining the importance of the meeting. Nowadays, the EADV congress is not just a European meeting, we have people participating from >100 countries, probably a lot more people than the original 21 founders expected!

Q: One of your research interests is psychodermatology. Could you explain a little about this interesting speciality and tell us if it is well-represented here at the EADV congress?

A: Yes, you are completely right, I am working in the psychodermatology field and the field of itch. This year, I was selected as the President Elect of the European Society for Dermatology and Psychiatry, so psychodermatology is really close to my heart. It is an interesting branch of medicine because it is a borderline between dermatology, psychiatry, and psychology; I feel that borderline fields are always more interesting than pure dermatology.

Psychodermatology has a special role, we can also discuss psychocardiology and psychonephrology too; however, the skin lesions are visible and it is a completely different situation to conditions where internal organs are involved. The skin is visible and plays an important role in communication, playing a critical role in generating the first opinion of a person. It is therefore not surprising that the problem of stigmatisation is rising and the person feels rejected from society; this is a huge problem for our branch of medicine. Of course, quality of life is an important common topic across all medicine, but I think that the secondary psychiatric problems, such as depression and/or anxiety, are just as important, as a result of the visibility of the lesions influencing the patient’s state of mind.

We should have a holistic approach to the patient, not only to treat the skin. Of course, this is crucial because if you treat the skin successfully you improve the psyche, but as treatment starts collaboration with psychologists should be encouraged to help the patient cope with the disease. That is why I think that psychodermatology is very important.

On the first day of the EADV meeting we were running a meeting of the sister society, the European Society for Dermatology and Psychiatry, there was also a session on psychodermatology and quality of life. I think that psychodermatology is quite well represented, but of course if you are working in the field you would always like to see more, that is why we are creating congresses on psychodermatology and itch. While psychodermatology and itch are included in the programme of the main congress, maybe we should fight more to have these areas addressed more comprehensively at the programme of the Spring EADV congress. I will keep my fingers crossed!

Q: Apart from learning about the latest dermatological research, what else do you enjoy about visiting EADV?

A: I enjoy seeing friends and other people at EADV, I must say that I have not had the opportunity to enjoy the city and the country; we are outside the city centre this time and I have had no time to explore. While I have not had time to visit the city centre due to my many obligations during the EADV meeting, I think that the main reason we come to EADV is to meet our colleagues and see what is happening in different countries, and to make new friends. In this way, your family is enlarging and I think that we will become one whole European family.

Q: Despite steady progress, some conditions, like melanoma, continue to become more prevalent in many parts of the world. Is this an issue of public awareness or of governmental policy?

A: I do not work in the melanoma field so I am not an expert, but the prevalence of some disorders is growing and they are becoming more common; this is not only for melanoma but also primary cutaneous lymphoma and other conditions, and the awareness of skin problems is important.

We have a media committee at the EADV and the members are trying to promote dermatology and skin problems but I think that all of us, as dermatologists, should work locally and on the European level to promote the importance of dermatology. Unfortunately, in some countries, dermatology is not considered a very serious branch of medicine as compared to branches such as cardiology and oncology. I understand that there are not as many life-threatening dermatological diseases but that is why psychodermatology is important; the burden of the disease is huge, so definitely, we should talk about it and promote both physiology and pathology of skin.

Q: Like with so many branches of medicine, rapidly evolving technology has drastically changed the face of dermatology. What technological developments do you expect to be highlighted at this congress?

A: Of course, there are several technological instruments that are helpful, but we must get better at diagnostics. So, for me, this is the most important aspect. There are some new developments creating better non-invasive methods to study and examine skin diseases. In my opinion, these developments are far from excellent, but I think that we are going in the correct direction. Nowadays, they could be treated as a supplementary method, but I think in the future, we will have more methods to diagnose skin disease effectively. Of course, we have made some developments in the treatment of skin conditions, especially with regard to aesthetic dermatology, but this is a different issue and here we are mainly concerned with medical dermatology, which is the field that I am working in.

Q: What role do international events, like the EADV congress, play in guiding national and international policy?

A: I think that the EADV congress does not influence local activities; however, during this meeting several important things happen. For example, the guidelines are discussed, this is important because the things that are created during the congress, not the congress itself, influence the local activities and practice in different countries. Also, I know that there is a standard and tradition in some countries that they pick up the news presented at the congress and then they disseminate this in their local communities. Of course, it is not possible that all the dermatologists from across Europe can come to the EADV congress; someone must stay to treat the patients, or there might be financial problems for some people coming from select countries as it is not a cheap congress to attend. Therefore, I think it is important that the news presented at EADV is locally distributed.

Q: Finally, what advice would you give to young dermatologists attending this event for the first time?

A: Firstly, I would advise a young dermatologist to become a member of the EADV; there is a category called Junior Member and there are plenty of advantages. First, the registration fee is completely different for the meeting, making it easier to come to EADV; secondly, there is also a possibility to participate in fostering courses organised by the EADV outside of the congress, specialised for residents.

This programme is working perfectly; I personally ran a course on itch, we had such a course organised this year in January in Brussels with 80 applicants for 20 places, so there is an interest. That is my first recommendation, become a member of the EADV and take advantage of it; if you are a member of EADV you will also receive the journal so you will be getting continued medical education provided by the academy. If you are at EADV Congress, select the topics you are interested in and plan your visit in advance so as not to lose time and take as much as possible from this meeting. 

 

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