A chance encounter between healthcare tech entrepreneur Varsha Thakoersing (Imcomet) and researcher Dr. Alina Rwei (TU Delft – Applied Sciences) may have a major impact on people with eczema and on the work of dermatologists. “We were both giving presentations at an event, ‘Science Meets Business Café’, and thought: someday we should collaborate.”
An innovation developed by Imcomet makes it possible to extract extremely small amounts of bodily fluid from inflamed skin. Rwei’s research focuses on the development of biosensors for real-time diagnostics of so called ‘biomarkers’. A biomarker is a measurable biological characteristic in the body, such as a protein, gene, or blood pressure level.
“When we met, it became clear that our work was complementary,” Rwei recalls. “We agreed that if an opportunity arose, we should definitely explore working together.” At the same time, both parties were independently in contact with the dermatology department of Erasmus MC.
Sometime later, TU Delft informed Rwei about opportunities within the WorkTech program to further develop labor-saving innovations together with the target group, in this case, dermatologists. “I immediately knew: this is an opportunity.” Together with Dr. Eveline de Geus (see textbox) from Erasmus MC, Rwei and Thakoersing decided to establish a consortium (“I-Sense”) and submit a proposal.
From ‘trial-and-error’ to personalized eczema treatment
The consortium is working toward a diagnostic tool for eczema. This tool is intended to reduce the reliance on the current ‘trial-and-error’ treatment selection for atopic dermatitis, also known as constitutional eczema, and support more targeted treatment decisions.
“Here’s how it works,” Thakoersing explains. “When someone with a severe form of eczema goes to the hospital, the dermatologist estimates the appropriate treatment and medication based on what they observe. The medication is then continuously adjusted throughout the treatment process, until it proves effective.”
The most suitable treatment differs from one patient to another, and even from one inflammation to the next. As a result, this trial-and-error process is time-intensive and leads to discomfort for patients, unnecessary healthcare costs, and additional workload for dermatologists.
Currently, around 400,000 people in the Netherlands alone are receiving treatment for eczema. “As the demand for dermatological care is expected to increase substantially in the coming years, workforce projections show that the number of dermatologists will fall far short,” says Thakoersing. The result: even longer waiting lists, more discomfort for patients, and increasing pressure on dermatologists. There is also the issue of laboratory work, adds Rwei. “For more precise diagnoses, samples currently must be sent to the laboratory. That also requires additional time and manpower.”
I-Sense aims to eliminate the trial-and-error approach to eczema treatment. Rwei: “The goal is to personalize eczema treatment more quickly.”
In the healthcare innovation program ‘WorkTech – Labour-saving innovations for Health, Welfare and Care’, Medical Delta, InnovationQuarter, and ZWconnect bring together practice partners, knowledge institutions, and technology companies in the province of South-Holland around a central question: how can labour-saving and workload-reducing innovations be optimally used to maintain the quality and accessibility of healthcare with fewer staff? WorkTech is co-funded through a PPS subsidy awarded by Health Holland to stimulate public-private collaborations. In 2025, six public-private partnership projects started.
‘Please make sure it can be done within fifteen minutes’
In this process, the entrepreneur and the scientist are working closely with the dermatologists at Erasmus MC, a requirement that was partly embedded in the WorkTech program. “They have been involved in the project from the very beginning, including in defining the research questions,” says Rwei. “We are in regular contact and, for example, participate in team meetings. Everything is done through co-creation.”
The challenge is to ensure that the final innovation fits seamlessly into existing clinical workflows. They quickly encountered one crucial condition: time. “The ambition is to immediately identify the underlying immune pathways driving a patient's eczema, which can help guide treatment selection right away,” explains Thakoersing.
“At first, we thought: you take a sample, send it to the lab, and have the patient wait. But that creates all kinds of practical and logistical issues: it disrupts existing schedules and workflows.” The dermatologists made it clear that the entire process needed to fit within a standard 15-minute consultation. “The assignment was clear: please make sure it can be done within fifteen minutes.”
Search for biomarkers
Both researchers got to work on the challenge, continuously coordinating with the dermatologists. A second prototype has now been developed for the tool that should be able to extract bodily fluid from inflamed skin almost painlessly. A prototype of the diagnostic platform is also under development. In addition, the team has identified several biomarkers that they hope can provide the right diagnostic information. Rwei explains: “That’s a search we are still very much engaged in. We are getting closer and closer.” The input from dermatologists is crucial in this process, she says. They help identify which biomarkers are likely to contain the most relevant information, allowing the researchers to focus their search more effectively.
Ideally, I-Sense will eventually be able to analyze multiple biomarkers. This would create a detailed profile that enables dermatologists to make highly precise, personalized diagnoses. “But we are starting with one biomarker. That alone would already be a huge step forward and would open the door to even more biomarker analyses and therefore sharper diagnoses.”
Ultimately, the innovation process should result in two devices that can sit directly on the dermatologist’s desk in the consultation room. “You can compare it to a COVID test,” says Thakoersing. “We use microneedles that are much smaller than conventional needles to take the sample, much like the swab used in a COVID test. It sounds simple, but it turns out to be extremely difficult and requires a great deal of innovation to develop. We then analyze the sample in a diagnostic tool, so the dermatologist can make a diagnosis within minutes. And all of this without using chemicals, allowing the process to take place directly in the consultation room. There is still a long road ahead before we get there, but that is what we are working toward.”
Different starting points, one shared goal
The collaboration between Imcomet as a private company, TU Delft as a scientific institution, and Erasmus MC as both a scientific and clinical partner was shaped by the structure of the WorkTech program.
“Everything needed for successful development is represented within the consortium,” says Rwei. Thakoersing adds: “The design of the program also creates focus. We have a clear end goal in mind: reducing the workload of dermatologists. From the very beginning, we have worked closely together. That has been decisive in the progress we’ve made.”
Especially in the early stages, adapting to the collaboration required some adjustment, Rwei explains. “We all speak different languages and approach things from different perspectives. That requires flexibility and openness to other viewpoints. Varsha is often the one who reminds us of our shared goals and interests, and that helps move us forward.”
Both explain that the approach to the project’s objectives is multifaceted. Imcomet, for example, focuses on scalability and commercial opportunities. For TU Delft, the scientific impact of identifying suitable biomarkers is also highly relevant, while developing a fast and effective analysis method presents an exciting technical challenge. Rwei: “Developing such a diagnostic platform is truly an engineering challenge.”
“But ultimately, it is above all the societal impact that personally motivates all of us,” says Thakoersing. “How wonderful would it be if we could help both healthcare professionals and patients with this? That’s what drives us.”
Dermatologists at Erasmus MC contribute to research and development
Dr. Eveline de Geus is a postdoctoral researcher in the Dermatology Department of Erasmus MC. From her department, she has been involved in the iSense project from the very beginning.
How can this innovation make dermatologists’ work easier?
“Dermatologists are generally quite capable of diagnosing atopic eczema through clinical examination. This is mainly done by visual inspection. If there is uncertainty, a biopsy is maybe taken, which is then analyzed in the laboratory. However, eczema occurs in different degrees, from mild to severe and because underlying immune responses differ, it is difficult to choose the right treatment.
With the iSense innovation, dermatologists would be able to gain certainty about the type of inflammation much faster and prescribe the right treatment earlier. This would also mean that patients would need to visit the clinic less often and receive effective treatment more quickly.
We are trying to bring the process of sampling and diagnosis within a standard consultation time of 15 minutes. One advantage is that a sample would no longer need to go to the diagnostics department for analysis and then only come back a few days later. If successful, it will save time on multiple levels for both patients and dermatologists.”
What input do you provide from the Dermatology Department, and how is this incorporated into the innovation process?
“We consult regularly. From our department, we help identify the right biomarkers: which substances in the immune system are interesting for us to measure? But also: what do we expect to be able to measure? On the other hand, Alina knows which substances can actually be measured, so the wishes and possibilities are gradually brought closer together.
Varsha develops the sampling technique and also coordinates it with us: we test whether the fluid is collected cleanly, or whether other substances are included that could reduce the quality of the analysis. We give feedback, and in this way we try to arrive at an optimal system. We collaborate well and learn from each other. For example, I learn a lot about what is involved in the final production process.
When collecting skin samples, it is important to consider the patient experience. A certain measurement method may work well, but it may also be painful for patients. We emphasize this aspect from our department. Once we move into clinical research, we will certainly involve patients as well. After all, an innovation may work very well, but it ultimately has to be used.”
Text: Sietse Pots
Photo's: Ilya van Marle - De Lichtjagers
