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Skin Disease Epidemiology and Health Data Research Group

Skin Disease Epidemiology and Health Data Research Group

We are a group of multidisciplinary academics working on a diverse portfolio of epidemiology research, largely focused on skin disease.

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About

We are a group of researchers working on a range of studies, largely focused on skin disease. Our work includes understanding more about the epidemiology of skin diseases.

About
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image of group of researchers smiling at camera

We are a group of researchers working on a range of studies, largely focused on skin disease. Our work includes understanding more about the epidemiology of skin diseases (epidemiology explores who gets sick and why), specifically: eczema (atopic dermatitis), antimicrobial resistance in acne, herpes zoster and skin cancer. One of our major goals is research aimed at improving the health and quality of life of people with eczema.

Our world-leading work aims to answer important health-related questions using innovative methods and using available health and social data to answer important research questions. The major programme of work focused on public engagement including art, theatre and digital storytelling which aims to enhance our research and communicate with the public in a better way.

We have made major contributions to developing reporting guidelines to improve the transparency of research reporting and impact. Our group includes people from different backgrounds – including doctors, epidemiologists, medical statisticians and public engagement professionals– this breadth of experience helps us produce internationally-recognised research.

Meet our team


Funding

We operate with the generous support of the Wellcome Trust, Horizon 2020 Innovative Medicines Initiative (IMI), The British Skin Foundation, The European Academy of Dermatology and Venereology, and Health Data Research UK (funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome Trust)

Public Engagement
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Eczema affects up to 10% of adults. Despite this, and although eczema is visible, there is limited public awareness of either the existence of eczema in adults or its effects on the individual. This awareness includes the impact of eczema on a person’s physical and mental health, social lives, educational attainment and economic prosperity. In this project we will engage adults with and without eczema in highly interactive ways to understand why adult eczema remains an “invisible visible” disease and how people perceive the impact of eczema on health and social outcomes in the long term.

Using art, photography, writing and theatre, we will bring adults with and without eczema together to understand how they perceive eczema affects long-term health and social outcomes. The outputs will be shared via these webpages to broaden and continue the discussion around the sociocultural aspects of adult eczema.

This project is funded by the Wellcome Trust, as part of a Research Enrichment – Public Engagement grant held by Professor Sinéad Langan, which is connected to her research using linked electronic health data to improve eczema diagnosis and outcomes.


Colouring Adult Eczema: Getting Under The Skin

Colouring Adult Eczema: Getting Under the Skin

Explore multiple layers of eczema from the physical to the emotional through craft, photography, and colourful lighting. This series of workshops aim to challenge stereotypes about the condition in society through the creation of a dynamic web art and digital storytelling project that will be launched to the public this September 2019.

We are seeking adults living with eczema to attend the workshops. Participants also have the option of bringing a +1 family member or friend with them.

Artists Peter Hudson and Julia Vogl are working with us and engaging with the public to creatively explore the spectrum of experiences of adults living with eczema and to help share these stories.

Workshop locations have included Manchester (June 29, 2019), Glasgow (July 13, 2019), Newcastle (July 14, 2019) and Nottingham (September 9, 2019). Stay tuned for upcoming workshops in London.

Contact: Naomi Asantewa-Sechereh


ECZEMA!

ECZEMA! is a 35 minute play written and directed by Maria Fusco, Professor of Interdisciplinary Writing, exploring what it is like to live in co-occupation and incessant dialogue with eczema, a skin disease affecting an estimated 15 million people in the UK, including Fusco, herself. One voice. One organ.

The play was originally commissioned by National Theatre Wales for the 70th anniversary of the NHS (July 2018), was updated for new performances at South London Gallery (June 2019) to include testimonials from a creative writing workshop held by Fusco with adult sufferers of eczema in February 2019, supported by a Wellcome Trust enrichment grant awarded to Professor Sinéad Langan. It was a dark comedy performed by Welsh actor Rhodri Meilir (PrideDoctor Who) who is in desperate dialogue with a great pipe organ, accompanied by organist, John Harris. The score was composed using motion-capture to translate scratching gestures (from Fusco) into music, to create a compelling vision of this ubiquitous skin disease. 

The play is available as a red vinyl limited edition EP, produced by Accidental Records.

Excerpts of ECZEMA! Filmed by Hydar Dewachi:

Praise for ECZEMA!

"An extraordinary text...the scored irritation progressed in paroxysmic rhythms, unleashing the auto-erotics and benignly directed passions of intense itching...a study of the body’s miscellany of culturally freighted products and vulgarities", Holly Pester, frieze.

"Eczema reminds us of the stranger and strangeness within ourselves", Daisy Lafarge, The White Review.

Visit Maria Fusco's website.

Find out more

Research
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Themes

Skin disease epidemiology

We are interested in the epidemiology of skin diseases, covering eczema (atopic dermatitis), antimicrobial resistance in acne, herpes zoster and skin cancer. Through our work, we aim to improve the health and quality of life of people affected by skin diseases, and specifically eczema.

Much of this research uses the extensive data collected in routine clinical practice in the UK and in other settings, including Denmark and the USA to help us answer the most important questions.
 

Eczema

Eczema is common, affecting 20% of children and up to 10% of adults (5.8 million people in England), and is becoming more common globally. Eczema is associated with major discomfort, stress and stigma for sufferers and incurs significant costs (estimated £465 million UK 1996).

Phenotypes

Eczema is commonly categorised into allergic and non-allergic subgroups (also known as phenotypes); it is clear that this separation is too simplistic. This poor categorisation of eczema subgroups limits our understanding of the causes, best treatments and our ability to predict future outcomes for patients.

Long-term outcomes

Recent studies suggest that eczema may be associated with major health and social problems, including heart disease. However, the existing studies are small, lack important information or cannot assess timing (i.e. does the outcome happen after the diagnosis of eczema). We are using international health data to assess the associations between eczema and major health and and social problems.

Gene-environment interactions

This work in partnership with the UK TREND eczema network addresses the evidence for gene-environment interactions in eczema.

ECO Programme grant

This programme of work, led by the University of Southampton and the University of Nottingham aims to improve eczema self-care.

BIOMAP

BIOMAP is a major programme of work funded by the Innovative Medicines Initiative and the European Commission, aiming to improve the lives of patients with eczema and psoriasis.

Acne and antimicrobial resistance

Antibiotics are very important to treat infections and can improve survival. However, there is increasing resistance to antibiotics. Antibiotic resistance is a big problem; if antibiotics stop working, then there are limited ways of treating infections. Many teenagers get acne and doctors often treat them with antibiotics for many weeks or even months. Antibiotics are used in acne for their anti-inflammatory effects (to reduce the redness and soreness of spots) not because acne is an infection. The study will find out how many people get repeated courses of antibiotics for acne, how many of those using antibiotics get difficult-to-treat infections, and how much this costs the NHS.

Bereavement and health outcomes

Stress is widely believed to play an important role in the onset of specific, common and important skin diseases, including psoriasis and eczema. However, we don’t have great evidence regarding the importance of stress in the onset of these disorders. We have been exploring the relationship between acute stress following bereavement of a partner and the onset of skin diseases. In our previous work, we found no evidence of a relationship between partner bereavement and herpes zoster. We are now extending this work to other health outcomes.

Herpes zoster

We have conducted a wide range of work on herpes zoster using UK and US data to demonstrate that the zoster vaccine is effective in preventing zoster and postherpetic neuralgia within routine clinical care, showing for the first time that the Zostavax vaccine was effective against postherpetic neuralgia in routine care. Our work has provided unprecedented understanding of risk factors for zoster and its complications and on management of zoster in primary care. This programme of work has been fundamental to informing guidelines on the prevention and management of zoster.

Skin cancer

We are leading the epidemiology and national database component of the UK Keratinocyte consortium of the British Association of Dermatologists in partnership with Public Health England.

Blistering skin diseases

We are working in partnership with the University of Nottingham to undertake research using linked UK health care databases to look at the incidence of two serious blistering skin diseases, bullous pemphigoid (BP) and pemphigus vulgaris (PV), and to explore whether incidence relates to sociodemographic factors.

Methods and reporting

The REporting of studies Conducted using Observational Routinely-collected Data (RECORD) is an international collaborative that developed reporting guidelines for studies conducted using routinely-collected health data (such as electronic medical record data, health administrative data, primary care surveillance data, and disease registries). The RECORD guidelines have been endorsed by many major journals. There is now an extension to RECORD to improve the reporting of pharmacoepidemiology studies (i.e. studies that explore the effects of drugs on disease) undertaken using routinely collected data. 

You can visit the RECORD website at: www.record-statement.org.

Health Data Research: www.hdruk.ac.uk.

Our team
Profiles

Sinead
Langan

Professor

Ketaki Bhate

Liang-Yu
Lin

Research Degree Student

Merce Grau-Perez

Kathryn
Mansfield

Assistant Professor

Amy
Mulick

Research Fellow

Angel
Wong

Research Fellow
Key public engagement contacts

Amanda Roberts

Peter Hudson

Colouring Adult Eczema
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