Important gaps in dermatology research

Kevin D. Cooper, M.D., professor and chair of dermatology at Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, and Steven R. Feldman, M.D., Ph.D., professor of dermatology, Wake Forest University School of Medicine, Winston-Salem, N.C., weigh in on important gaps in dermatology research today.

Measuring results

Interestingly, one of the gaps in dermatology research is the specialty’s lack of outcomes measures, Dr. Cooper says. “Research in outcome measures is needed in dermatology, and it’s being done. The American Academy of Dermatology is working on trying to get consensus outcomes measures for a variety of inflammatory and neoplastic skin diseases,” Dr. Cooper says.

Understanding adverse events

Dr. Cooper says he doesn’t think the specialty has a good grasp of adverse events. An example at the practice level is how often do your patients get an adverse reaction when you prescribe antibiotics?

Drug targets transitioning to drugs

Derm research doesn’t always attract coveted attention from big pharma, according to Dr. Cooper, because skin diseases aren’t as financially attractive as cardiology, for example. Because of that, dermatology has many more “druggable” targets than there are drugs being developed, he says.

Engineering a human skin model

An area of research that is needed in the specialty and is underway is in developing a three-dimensional human skin equivalent model, Dr. Cooper says. “We have animal models. Those models are really useful for segments of disease, but there is a gap in understanding how well they actually model human skin disease. How well do they model eczema, psoriasis, melanoma?” Dr. Cooper says.

Better imaging techniques

Imaging is yet another research area that needs focus in the specialty, Dr. Cooper says. “A lot of other fields have very sophisticated imaging. And we have some imaging devices to try and computerize the features that are being seen by the eyes, but it’s still pretty much what we see. Can we image the cells that are moving? Do we know what the cells are doing functionally versus having a static biopsy?” Dr. Cooper says.

Understanding bugs and derm disease

Translating our understanding of microbiome to therapeutic interventions remains a mystery. Among those questions, according to Dr. Cooper: How do the bugs that we carry influence diseases that we have or the function of those diseases?

Understanding healthcare disparities

Dermatology lacks a solid understanding of where socioeconomic, ethnic and other disparities exist, and how healthcare systems and access to healthcare affect disparity-related health outcomes. "There are people out there with severe acne getting scars. In theory, there's probably no reason why anybody should ever have a scar from acne. It's treatable, we can prevent severe acne, we can cure the disease, but we have people running around who aren't in our offices and we're not getting to provide them the therapy," Dr. Feldman says.

Connecting the skin and brain

Research focused on the skin-brain connection in dermatology is not getting the attention it deserves, some say. That includes studies on psychosocial impacts on skin disease and behavioral research. More knowledge about how emotions and behaviors affect compliance, disease and outcomes would be a big boost in dermatology, where many patients struggle psychologically with skin issues.

READ MORE:

Sophisticated research capabilities, big data accelerate discoveries of mechanisms, drug targets

Drug delivery options a hot research focus

Closing gaps in psoriasis research

Tips for junior investigators

Compliance is shockingly understudied