Features of emergency remote dermatological care in wartime

Abstract

On February 24, 2022, the sudden aggression of the Russian Federation against Ukraine began. The usual way of life has changed. Due to the real risks to life, the traditional majority of medical services and outpatient consultations have become impossible. The question arose as to how to provide dermatological care to patients in this situation. At this time, especially useful was the use of the Internet, namely Facebook and Telegram.
 Materials and methods. We created several posts on Facebook where announced free online medical consultation during the war. Moreover, a Telegram channel was created. Any doctor could register there at will, and with the help of a bot they received requests from patients in their specialty. 
 Results and discussion. For the first 10 days of war, we received around 200 requests from patients with dermatological problems. Most (95 %) of these patients had allergic reaction or herpes, others had an exacerbation of psoriasis or pityriasis rosea.A comparative analysis of patients’ appeals showed a sharp increase in allergic skin diseases caused by the herpes virus. Moreover, such allergic reactions have been observed in people who have not previously had similar skin problems. In two cases of herpes simplex, the rash spread to the entire skin of the face, which could have been caused by sudden and significant stress due to information about bombings and rocket attacks. Only one patient who has approached us since the beginning of the war had hemorrhagic vasculitis due to severe comorbidity and not directly due to stress. Unfortunately, in the future we will probably only see a worsening of this situation. The consequences of prolonged stress due to forced stay in the war zone will have a negative impact on the health of our patients for a long time to come.
 Conclusions. The transition to remote medical counseling for dermatological patients, forced by wartime circumstances, proved to be quite successful in terms of its clinical results, although it significantly reduced the number of such appeals. At the same time, it allowed more extensive use of free remote assistance from foreign clinicians. Both in the initial unmotivated appearance of various skin rashes and in the exacerbation of chronic dermatoses, the objective stressful situation of the sudden Russian military aggression was dominant.