Relationship with the Department of Dermatology of the  University Medical Center Groningen

Many abroad think that I have or have had an affiliation with the UMC (University Medical Center) Groningen. This is probably because a large number of publications have appeared with both me and one or more staff of the Dermatology Department of the UMCG as authors. However, I never worked there after my dermatology training, but I do have a special bond with the clinic. In 1979, in the last year of my training as a dermatologist in Groningen, Prof. Klokke asked me to stay on as chef de policlinique after completing the training. I have'nt accepted his proposal, because Klokke didn't want to give me the opportunity to do my PhD. The professor was angry when I announced my departure and it was noted in the minutes of the meeting of the clinic's Board that 'De Groot had brought the clinic into serious trouble'.

When I came to live in Wapserveen in 2005 and the renovations and landscaping were more or less finished in 2007, I contacted the then professor, Marcel Jonkman, to ask if I could do some volunteer work for the clinic. I could indeed, he said, but he definitely didn't want me to work as a dermatologist, not even on a non-formal basis. He had very bad experiences with it. When he was appointed professor in 2003, a retired dermatologist had already worked in the clinic  for some time – without formal appointment, I believe – as chef de policlinique. He probably did this very well, he had been a highly respected dermatologist working in a non-academic hospital. Matter of fact, the assistants were trained by him and they were very satisfied with the education he provided. So when Marcel, who also came from the Groningen clinic (he had attended my PhD as an assistant in 1988), was appointed professor, he wanted to remove the dermatologist acting as chef de policlinique. But when he tried to get rid of him, all hell broke loose among the trainees and the situation has remained very tense and relationships strained for a long time. That wouldn't happen to him another time with me, he may have thought, so working in the clinic was out of the question!

Teaching junior interns

However, Marcel had another job for me, he said. But first he showed me the infamous minutes of the 1979 meeting; of course he wanted to know what kind of meat he got in the tub. I explained the situation, we both had a good laugh over it and since 2007 until the corona crisis started in 2020 I have periodically, once every 6 weeks, taught junior interns general dermatology for 1.5 hours. Everyone was satisfied with that: the staff members (who did not have to provide this education themselves), the students (I always received very good assessments) and myself too, mostly I enjoyed teaching. I did not teach in the classical sense of lecturing, but gave an 'interactive presentation'. I would show a large number of clinical images and then I asked questions about them: who knows what it is, what 

would you do with it, can it harm the patient, etc. In advance, I would always reassure them: 'Don't be afraid to speak up. Experience shows that you know much more than you think or at least than you dare to say. No one is laughed at'. By the way, we always had many laughs, especially because of all the anecdotes I told and jokes I made. Some groups were downright bad, the interns knew little, said almost nothing of their own accord and then I had to pull it out of them, so to speak. But other groups were very active and that was nice and stimulating. Afterwards I would go home tired, but satisfied, at 6 pm. Just had to drive home for an hour, which was less enjoyable, especially during winters.

Unpaid parttime appointment as 'counselor'

The appointment (20%, unpaid) that I have had since 2007 and which was renewed every year or 2 years, was that of 'counselor', which meant nothing, as I never counseled anyone from the clinic. However, the appointment was very important to me because it gave me access to the medical library of the UMCG with thousands of digital journals, books and useful websites via a proxy account (which allowed me to log in at home). This has enabled me to write all the articles and books published after 2007; without access to the library this would have been absolutely impossible. In 2020, to my great pleasure and relief, my appointment was extended again until September 30, 2021. I had been a bit worried about that, because I had announced that I no longer dared to teach because of the corona issue. Fortunately, people understood this and by far most forms of education have since then no longer been held in the traditional form anyway, with the physical presence of teachers and students, but online. In September 2021, I no longer requested an extension. It was abundantly clear to me that corona would not go away, and I had no intention of teaching again in those small stuffy rooms with 20 or more interns. My age (70 in 2021) obviously was a risk factor for becoming seriously ill. No staff member ever thanked me for the 14 years of voluntary teaching, which was a bit disappointing. I am quite sure Marcel would have contacted me, but he had died suddenly a few years before.

Allergic contact eczema around the eyes is usually caused by cosmetics. That is very unlikely in the patients above: an 80-year-old man does not use cosmetics there and a unilateral eczema due to cosmetics would be rather odd. The gentleman on the left had become allergic to drugs (beta blockers) in eye drops against glaucoma (high intraocular pressure). The patient with the very severe eczema around the left eye with massive swelling of the eyelids had been to the ophthalmologist 4 days before. During consultation he had received drops in his left eye to dilate the pupil (a mydriatic drug), which facilitates the examination by the ophthalmologist. Because the eczema set in 2 days later, he must have been allergic to this mydriatic at that time already. Inquiries showed that the patient had had this examination before, and also the drugs, in the eye clinic. The last time he had become allergic to it (sensitized), but the eczema then only appears after a subsequent (repeated) contact. Important to know: contact allergy is an acquired allergy, you must have had contact with the substance once or more times before you can become allergic to it.

Current situation (early 2022)

Currently, because of my expertise in this area, I am still periodically asked to review articles written by the trainees of the dermatology clinic about contact allergy and to give advice. The current head of the allergy department of the clinic, Dr. Marie-Louise Schuttelaar, can of course do this herself, but critically assessing an article takes a lot of time and she doesn't have that. Staff working overtime seems to be normal these days!

I no longer have an appointment in Groningen and I no longer teach. Fortunately, I was able to arrange with the UMCG library that I will keep my proxy account until the end of 2023 and therefore have access to all library facilities. Let's just hope that I can finish volume 5 in the Monographs in Contact Allergy series on Rubbers and Plastics, which I plan to start in September this year (2022), before the end of next year. Fortunately, Thomas Rustemeyer, the professor of Occupational dermatology in Amsterdam, has already offered to arrange a 'guest account' for me at his university library, when I no longer have access in Groningen.


Problem solved. I now have an (unpaid) appointment at the Academic Medical Centers Amsterdam for a year. My task is to counsel (hurrah) doctoral medical students in their scientific master projects. Fortunately, I can do all my work from home (hurrah once more, as Amsterdam is 2 hours from my domicile). And when my acces to the Groningen library ends December 31st this year, I can switch to the Amsterdam library. I have decided not to write volume 5 in the Monographs in Contact Allergy series, far too much work (it would definitely take more than 2 years) and, if I am honest, also rather difficult with a lot of chemistry (of which I know little). However, I am currently writing review articles on contact allergy to acrylates-containing nail cosmetics and their main allergenic ingredients, with Thomas Rustemeyer as co-author. The first part has already been accepted for publication in Contact Dermatitis.      


Publications with Groningen staff members and dermatology trainees

The articles that I have written since 2007 together with one or more staff of the dermatology department of the UMCG and trainees are listed below. The names of the Groningen co-authors are in bold.

  • De Groot AC, Terra JB, Jonkman MF. Hoe schrijf je een wetenschappelijk artikel? Ned Tijdschr Derm Venereol 2007;17:394-401
  • De Groot A, Stoof T, de Beer H, von Blomberg M, Conemans J, Jonkman M, Mulder C. Dermatitis herpetiformis. Aanbevelingen uit de Richtlijn. Ned Tijdschr Derm Venereol 2008;18:422-423
  • De Groot AC, Flyvholm M-A, Lensen GJ, Menné T, Coenraads PJ. Formaldehyde releasers: relationship to formaldehyde contact allergy. I. Contact allergy to formaldehyde and inventory of formaldehyde-releasers. Contact Dermatitis 2009;61:63-85
  • De Groot AC, Flyvholm M-A, Lensen GJ, Menné T, Coenraads P-J. Formaldehyde en formaldehydedonoren. I. Formaldehyde, een lastig contactallergeen. Ned Tijdschr Derm Venereol 2009;19:350-355
  • De Groot AC, Lensen GJ, Coenraads P-J. Formaldehydedonoren: een overzicht. Ned Tijdschr Derm Venereol 2009;19:581-588
  • Jonkman MF, de Groot AC, Slegers TPAM, de Jong MCJM, Pas HH. Immune diagnosis of pure ocular mucous membrane pemhigoid: indirect immunofluorescence versus immunoblot. Eur J Dermatol 2009;19:456-460
  • De Groot AC, White IR, Flyvholm M-A, Lensen G, Coenraads P-J. Formaldehyde-releasers: relationship to formaldehyde contact allergy. II. Formaldehyde-releasers used in cosmetics. Part 1. Characterization, frequency and relevance of sensitization, and frequency of use in cosmetics. Contact Dermatitis 2010;62:2-17
  • De Groot A, White IR, Flyvholm M-A, Lensen G, Coenraads P-J. Formaldehyde-releasers: relationship to formaldehyde contact allergy. II. Formaldehyde-releasers used in cosmetics. Part 2. Patch test relationship to formaldehyde contact allergy, experimental provocation tests, amount of formaldehyde released and assessment of risk to consumers allergic to formaldehyde. Contact Dermatitis 2010;62:18-31
  • De Groot AC, Coenraads P-J. Twenty-five years quaternium-15 in the baseline series: does it deserve its place there? Contact Dermatitis 2010:62:210-220
  • De Groot AC, Le Coz CJ, Lensen G, Flyvholm M-A, Maibach HI, Coenraads P-J. Formaldehyde releasers: relationship to formaldehyde contact allergy. Formaldehyde-releasers in clothes: durable press chemical finishes. Part 1. Contact Dermatitis 2010
  • De Groot AC, Le Coz CJ, Lensen GJ, Flyvholm M-A, Maibach HI, Coenraads P-J. Formaldehyde-releasers: relationship to formaldehyde contact allergy. Part 2. Formaldehyde-releasers in clothes: durable press chemical finishes. Contact Dermatitis 2010;63:1-9
  • De Groot AC, Geier J, Flyvholm M-A, Lensen G, Coenraads P-J. Formaldehyde-releasers: Relationship to formaldehyde contact allergy. Metalworking fluids and remainder, part 1. Contact Dermatitis 2010;63:117-128
  • De Groot AC, Geier J, Flyvholm M-A, Lensen G, Coenraads P-J. Formaldehyde-releasers: Relationship to formaldehyde contact allergy, part 2. Metalworking fluids and remainder. Contact Dermatitis 2010;63:129-139
  • De Groot AC, Blok J, Coenraads P-J. Relationship between formaldehyde and quaternium-15 contact allergy. Influence of strength of patch test reaction. Contact Dermatitis 2010;63:187-191
  • Volkering RJ, de Groot AC, Woutersen M, Schuttelaar M-LA. Allergisch contacteczeem door het gebruik van massageolie. Ned Tijdschr Derm Venereol 2019;29:14-17
  • Van Amerongen CCA, de Groot A, Volkering RJ, Schuttelaar MLA. Cheilitis caused by contact allergy to toothpaste containing stannous (tin) – two cases. Contact Dermatitis 2020;83:126-129                                                                             

Suggested next chapter: