Eczema is an inflammatory skin condition, characterised by dry, itchy and red skin. Childhood eczema is usually the ‘atopic’ type, which commonly starts in childhood, often runs in families, and is linked to allergies and other allergic conditions like asthma and hay fever. NIHR and School funded studies on childhood eczema have been instrumental in paving the way in this previously under-researched field in primary care. Many of the key findings, from trials to date (antibiotics, silk clothing, vitamin supplements and water softener) have provided negative results, which are useful to rationalise treatment. Research is now considering the use of established interventions, such as emollients, to look at the best way to use them in a treatment plan.
Studies conducted by SPCR members at the Universities of Bristol and Southampton by Drs Matthew Ridd, Miriam Santer and Beth Stuart, working closely with Professors Hywel Williams, Kim Thomas, and Dr Joanne Chalmers from the University of Nottingham’s School of Primary Care, are featured in the new NIHR Highlight on Childhood Eczema, published by the NIHR’s Dissemination Centre in September this year. The Highlight presents findings from a range of projects which look at a variety of treatments for childhood eczema, and present the views and experiences of parents, children and carers.
The researchers were initially brought together by the establishment of a SAPC Dermatology Special Interest Group, set up by Matthew Ridd in 2011 to promote research on the prevention, diagnosis and management of the skin problems commonly seen in primary care. They meet regularly to discuss ideas and research proposals with a view to forming multi-disciplinary collaborations.
“The SAPC skin special interest has really brought us all together and has led to many of the collaborative studies.”
- Professor Kim Thomas, University of Nottingham
Bristol’s early involvement in research on childhood eczema was led by Matthew with the SPCR funded POPPIE (Predictors of Onset, Persistence and Psychological Impact of childhood Eczema) study which resulted in further collaborations between the three universities. The CREAM (ChildRen with Eczema, Antibiotic Management) study, a three arm trial assessing the value of topical or oral antibiotics in clinically infected childhood eczema study was funded by NIHR HTA, led by Nick Francis from the School of Medicine in Cardiff and in Bristol by Matthew. Another collaboration between the three universities looks at the prevention of eczema through the use of emollients from birth (the BEEP study) led by Nottingham.
The NIHR-funded Programme Grant for Applied Research Eczema Priority Setting Partnership was led by the University of Nottingham with Matthew contributing as a member of the Steering Group and Miriam attending the final consensus workshop. The partnership identified research priorities around the treatment of eczema from patients, carers and healthcare professionals. It was overseen by the James Lind Alliance and included patients with eczema, their parents or carers, and the healthcare professionals who treat them.
The COMET study was conceived to address one of the top priority questions from the priority setting partnership: “Which emollient is the most effective and safe in treating eczema” and was the feasibility trial for BEE (Best Emollient for Eczema). Matthew (Chief Investigator) and the team from Bristol, Nottingham and Southampton, received £1.4 million from the NIHR Health Technology Assessment Programme to discover the best moisturiser for treating childhood eczema. Read more about the study.
The BATHE study (Bath Additives for the Treatment of cHildhood Eczema) was funded by the HTA to examine the effectiveness of bath additives/emollients for childhood eczema, led by Miriam Santer in Southampton, Matthew Ridd (Bristol), Nick Francis (Cardiff) and Kim Thomas (Nottingham).
The ambitious new Trial of Eczema allergy (TEST) project, funded by SPCR, addresses the priority question: “What role might food allergy tests play in treating eczema?” and is led by the University of Bristol in collaboration with Southampton and Nottingham. Beginning in October this year, the trial will help make decisions about whether routine allergy tests for children with eczema are helpful or not. Read more about the SPCR funded study.
A prestigious NIHR Programme Grant for Applied Research (PGfAR) award, co-led by Miriam Santer and Kim Thomas, will explore the best ways of supporting eczema self-management using online technology. This ambitious programme of work started in September 2017 and will run for the next five and a half years.