Dermatology (Skin conditions)

Research, Development and Education

Dermatology Services has close links with Newcastle University and is recognised as one of the leading academic dermatology departments in the UK.

One of our main strengths has been the interaction between clinical investigation and laboratory science. This has resulted in research discoveries being translated into improvements in patient care. 

Our clinical and non-clinical researchers are based in the Institute of Cellular Medicine and the Institute of Genetic Medicine at Newcastle University.

Partnership working

Because the skin acts as a barrier to the outside world, we work closely with colleagues and partners to understand the skin’s responses to environmental signals. This includes drugs, chemicals, foreign antigens and ultraviolet radiation). You can get more details on the Newcastle Biomedicine website.  

Research projects

You can find out about some examples of our successful research projects and on-going research:


Treatments for atopic eczema

Ultraviolet B (UVB)

Around 2% of adults in the UK have ‘atopic eczema’, with approximately 15% of them having moderate-to-severe eczema that usually lasts for a prolonged time. The treatment options for patients with refractory atopic eczema that isn’t adequately controlled by creams and ointments, are limited.

Our research team led a trial of 69 adult patients with moderate-to-severe atopic eczema. The trial compared different forms of ultraviolet treatment (delivered through special cabinets in the dermatology department). Patients attended twice a week for 12 weeks. ‘Narrowband ultraviolet B’ was compared to ‘broadband ultraviolet A’ light (as used in commercial sunbeds), and visible-light. It was the first randomised controlled trial of narrowband UVB phototherapy for atopic eczema, and its results were published in the Lancet. Narrowband UVB was demonstrated to be an effective treatment for atopic eczema. The benefits were maintained for several months after the therapy ended, and this type of treatment has been adopted into widespread clinical practice across the UK. This work has also been incorporated into national and international guidelines on the management of atopic eczema.

Azathioprine

Ultraviolet B treatment is not suitable or convenient for all patients. Dr Meggitt and Prof Reynolds therefore led a regional trial of a systemic (tablet) treatment with azathioprine, in adult patients with moderate-to-severe atopic eczema. It was the first ‘parallel-group randomised controlled’ trial of azathioprine for atopic eczema, and the first trial for a dermatological condition where dosing was tailored to patients based on the ability of their body to use the drug. The results were published in the Lancet. The drug significantly improved symptoms in patients and disease activity reduced by more than one third in the drug-treated group. Improvements in disease activity were matched by improvements in patients’ symptoms and quality of life scores. This research has had widespread impact across the NHS for the benefit of patients. Azathioprine has been adopted widely in the UK as a treatment for refractory atopic eczema, and is now the most popular choice of drug in tablet form. This research has also been incorporated into national and international treatment guidelines for atopic eczema.

Hand eczema phototherapy study

Hand eczema is a huge clinical problem with up to 10% in the general population – and more in groups such as healthcare workers – with the condition. If topical treatments (creams) do not work, the next option is often some form of ultraviolet light treatment. Traditionally Psoralen UVA (PUVA) has been used. PUVA is quite time consuming to receive and if used too much can lead to an increased risk of skin cancer. Narrowband UVB light is a different form of UV therapy which is often used to treat eczema on the body but has never been formally investigated for hand eczema. A team is conducting a study to compare NBUVB with immersion PUVA for ‘palmar hand eczema’.

Alcohol and skin diseases

Does psoriasis make people drink alcohol or does alcohol trigger or worsen psoriasis? This remains an unanswered question, as does whether other inflammatory skin diseases are associated with alcohol. A study is underway to investigate the alcohol intake of patients with psoriasis, eczema, lupus, other inflammatory skin diseases and lesions using the Alcohol Use Disorders Identification Test (AUDIT). We are also recording other information such as the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale along with background clinical data. We hope to gain insights into whether alcohol is the trigger for skin disease or whether patients drink to excess because of their skin disease.

Translational rare skin disease research

Topical kinase inhibition therapy for cutaneous cylindromas

Around 1 in 100,000 people in the UK suffer from a rare skin condition that leads to the development of multiple, disfiguring, skin tumours called cylindromas on the scalp and body. The condition is caused by an inherited genetic mutation. Up to 1 in 4 affected patients require complete scalp excision to control the tumours. The lack of alternatives to surgical procedures led researchers at Newcastle University and the Institute of Cancer Research, London, to conduct comprehensive genetic analyses of cylindromas. The research team will conduct a trial of a topical treatment in affected patients, and hopes to demonstrate that treating patients with this inherited skin tumour in this way represents a safe and feasible approach to treatment.

Targeting skin white blood cells for melanoma therapy

A research team is investigating the potential of targeting skin white blood cells to stimulate the immune response to kill melanoma cells. This strategy will deliver treatment directly to the skin and minimise adverse effects.

Mapping of skin white blood cells to improve vaccination strategies

Vaccination is routinely administered by an injection into muscle. Vaccine delivery into the skin has many advantages, including reduced amounts of vaccine needed to induce protective immune response. A research team is exploring the feasibility of targeting specific cells in the skin to enhance vaccination strategies. The studies demonstrate unique three-dimensional organisation of white blood cells around skin blood vessels. 

Psoriasis Stratification to Optimise Relevant Therapy

This project is working to create a new test to help doctors work out which treatment is most likely to improve psoriasis, based on a patient’s individual biological make-up.

The research team, known as Psoriasis Stratification to Optimise Relevant Therapy (PSORT) is a partnership between five UK universities: Manchester, Newcastle, King’s College London, Queen Mary and Liverpool, 10 pharmaceutical and diagnostics companies, the Psoriasis Association and NHS partners representing patients.

The four-year study will develop a targeted approach to treatment which could soon become reality for the one million NHS patients who suffer from the painful and potentially embarrassing skin condition. It will use modern techniques to investigate different factors that may influence how well a particular treatment works.  This will include studying the levels of the drug in a patient’s body – which vary from person to person even when they are taking the same dose; changes in the skin and blood; and differences in a patient’s genetic make-up. Bringing all this information together will help to predict an individual’s response to a particular treatment. This means patients will benefit from more effective treatment for their psoriasis that is individually tailored to them.

You can see more information on the PSORT project website.

© Copyright Newcastle upon Tyne Hospitals NHS Foundation Trust 2018 Site by TH_NK