Clue for skin disorder may be uncovered in tiny patients

Looking deep beneath the surface to find a more effective treatment for a common skin disorder, local doctors are studying the tiniest patients with hopes to uncover big clues.

Renata Musial, mother of child with eczema: “It’s a daily battle.”

But on this day, nine-month-old Roman looks happy and healthy. Gone are the battle scars of the skin disease he’s suffered from since shortly after his birth: eczema.

Renata Musial: “A lot of redness, he seemed to be itching a bit. Started getting really bad, went from his face to his body. Putting pajamas over his skin made him hurt and uncomfortable, couldn’t lay still. His skin had lesions all over his back, really sore, pussing, oozing, trouble sleeping. We weren’t sleeping, ramped up pretty quickly.”

25032970It’s a cycle doctors know well from the surface. Studies in adults have offered clues, like an association with allergy, but little is known about how the disease is triggered in babies.

Lurie Children’s Dermatologist Amy Paller is digging deeper.

Dr. Amy Paller, Dermatologist: “We really don’t know the underlying cause of eczema in children. It’s hard to ask for a blood sample from a baby. It’s hard to get even a tiny little biopsy of the skin.”

But the tools have changed. With more sensitive techniques at their fingertips, doctors can learn more from less.

Dr. Paller: “A few years back we didn’t have some of the studies that we’re able to do now, to look at exactly what’s happening in the genetics of the skin, exactly what’s happening to the proteins that are there. We are now able to use genetic techniques to look at thousands of genes at the same time. We’re also able to do very sensitive protein analysis that’s just been available in the last few years so that we can detect changes in small amounts of blood or skin that could not have been done in the past. How exciting is that?”

The idea is to travel beneath the skin’s barrier to find the root cause of eczema, then develop a more targeted—not just topical—treatment.

Dr. Paller: “We’ve been using steroids for 40, 50 years perhaps, to treat eczema and we’ve really had very little in the way of new discoveries, and nothing that’s targeted. We’re ready to move on to children and babies.”

It’s a hopeful time for parents like Renata Musial. Weekly bleach baths and topical steroid ointments help keep Roman’s eczema under control. Still, his mother signed on for Dr. Paller’s study.

Dr. Paller: “Roman’s the type of child we’re worried about. We want to know what’s going on, we want to know what the best treatment is for him so he was ideal for the study, and fortunately the family obliged.”

Renata Musial: “I’d do anything for this child. I want other kids to not go through the same thing.”

Dr. Paller would like to enroll 60 more babies and young children in her eczema study.

To learn more about Dr Paller’s eczema study, go to:

http://www.luriechildrensresearch.org/clinical_trials/derma/

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