Shedding new light on skin diseases: developing new biophotonics methods to image skin structure, how this is damaged by skin diseases and how new therapies can improve it. (EEE-20-Matcher)

Details

Atopic dermatitis (AD - also known as eczema) is a skin disease that is greatly underestimated both in its prevalence and in its negative effects on sufferers. The physical sensation of trying to sleep whilst experiencing a severe eczema "flare" has been likened to putting on a wet-suit that is stuffed with stinging nettles, zipping it up and then lying down to try to sleep. AD first affects the very young, with symptoms often appearing in the first 6 months of life and persisting through school years. Having open, weeping sores on the skin can cause children to have serious emotional problems at school and the lack of sleep from severe nighttime itching leaves children exhausted, unable to concentrate and thus unable to keep up. In severe cases attempted suicide is not uncommon, even in children under 10 years of age.

The burden on carers is similar to that from children who need e.g. to be fed through a tube at home. Yet AD is a very common condition, affecting up to 30% of children in the UK and up to10% of all adults. The UK has one of the highest rates of AD in the world and the disease is the commonest reason for consulting a GP about a skin complaint. AD is a "disease of the modern world": rates of AD have increased dramatically since the 1940's, suggesting that an increase in external irritants is a major factor. AD belongs with asthma and hay fever in being primarily an "allergic" reaction. The financial burden of AD on the health service arises because it is the first step along the "atopic march", where a child with AD very often progresses on to one of these other conditions.

Despite its potential severity and high prevalence, AD has been neglected as a priority for developing treatments. The most commonly prescribed treatments (moisturizing creams and steroid creams) are over 50 years old. Steroid creams are very effective for calming inflammation and itching but come with serious problems. Sufferers can become dependent on them (steroid addiction) but at the same time they gradually damage the skin ("skin thinning"). Many carers suffer from "steroid phobia" and under-treat children; this causes AD flares to be poorly controlled which then requires even more steroid cream to be used later.

This regrettable situation has begun to completely transform however. New treatments are being brought to market which control inflammation and itching with potentially far fewer side-effects than steroid creams. The companies developing these treatments urgently require objective tools that can assess the skin before, during and after use so that they can reliably measure how well the treatments suppress AD flares and avoid causing skin damage. At Sheffield we have a unique collaboration between dermatologists and optical coherence tomography (OCT) engineers to deliver these tools. A recent, large EPSRC research grant has allowed us to build 3 highly novel OCT systems and this PhD project will seek to apply them in the clinic and see what extra information they can provide to help monitor eczema and the effects of new eczema treatments.

Interested candidates are strongly encouraged to contact the project supervisors to discuss your interest in and suitability for the project prior to submitting your application.

Please refer to the EPSRC DTP webpage for detailed information about the EPSRC DTP and how to apply.

Apply here: Application Form (sheffield.ac.uk)