GD06 An observational study of the impact of the Ukraine war in our dermatology department

Abstract We aimed to assess the cohort of patients attending our dermatology department who have been displaced by the war in Ukraine, to evaluate the impact of the conflict on the continuity of medical care, and to shed light on the challenges faced by political refugees in an unfamiliar medical system. Consenting Ukrainian refugees attending our department over a 3-month period answered questions regarding their displacement, medical history, and reason for referral to the dermatology service. We assessed the impact of their care on our department including translators, treatment plans and further follow-up appointments. We also present a single patient’s story, highlighting the devastating impact political conflict can have on patient care. Seventeen patients participated in the study. Most patients (82%) arrived in Ireland over 1 year ago. Thirteen of the presenting complaints (76%) occurred prior to displacement. Six patients were referred for assessment of a rash and 11 with lesions. Working diagnoses included benign naevi (35%), skin cancers (29%) and inflammatory dermatoses including eczema, psoriasis and tinea (35%). Four patients had translators booked, while the remainder communicated through family members or an online translator service. In total, seven patients required excisions, two required systemic treatment and one required biologic treatment. The remaining 10 patients were discharged from dermatology. We also present a single patient’s story. The patient was a 46-year-old woman referred to dermatology with psoriasis for which she was previously on maintenance treatment with methotrexate in Ukraine. She incidentally had a lesion recently excised in Ukraine, from which she never got the results due to the war. Following her displacement she subsequently developed pain and swelling around her surgical site. Investigation revealed what was likely metastatic melanoma. Political conflict can lead to fractured patient care, catastrophic outcomes and increased pressure on thinly stretched healthcare resources. Our hospital’s immediate catchment area has accommodated just under 10 000 Ukrainian refugees to date and we have seen some of the deleterious effects this conflict has had on patient care as a consequence. Nevertheless, we must continue supporting political refugees to the best of our ability, keeping in mind the impact of displacement on their care.