THE DERMATOPHARMACOLOGY UNIT, THE UNIVERSITY OF...

THE DERMATOPHARMACOLOGY UNIT, THE UNIVERSITY OF MANCHESTER, SALFORD ROYAL NHS FOUNDATION TRUST

skin

august 2012issue 5

research

Brain-skinaxis

The relationship between stress and the skin examined

The

01

The aim of this newsletter is to keep you informed of dermatology news, as well as studies that you might be interested in. If you do

not wish to receive this newsletter email; [email protected]

with the subject “unsubscribe” or phone 0161-206-8077.

CONTACT THE EDITOR: Susan Moschogianistel: 0161-206-8077

email: [email protected] visit: www.medicine.manchester.ac.uk/skin

Manchester Skin Research@McrSkinResearch

Regulars

SpotlightThis issue we highlight the work

Sara Wilson (PA) &

Carol Sewell (Research Secretary)

IMPACT UpdateThe team have been in touch to give

an update on Manchester’s NIHR

IMPACT programme of research

News in BriefIncluding: skin experts battle the

elements to raise money for charity,

upcoming events

page 6

page 19

page 21

page 3

page 8

page 9

page 14

page 17

page 18

Features

The brain-skin axis The relationship between stress and

the skin examined

BSIDManchester group celebrated at

The British Society for Investigative

Dermatology conference

Ask an expert...A selection of common skin

questions put to our panel

Health and Safety engagement week Skin research represented at The

University’s first engagement week

Top Sun Safety tips How to keep your skin safe

this summer

BBC Horizon Professor Chris Griffiths featured in

top science documentary

We thank La Roche-Posay for sponsoring the printing of this publication

02

Foreword

Much has been in the news recently about the need for specialist services for people with skin conditions. Almost half the UK population will have some form of skin problem every year- most commonly acne, eczema or psoriasis. However, the wide-ranging impact of living with a skin condition is often underestimated. All aspects of a sufferer’s life can be impacted, including employment and personal relationships.

This edition of our newsletter focuses on the relationship between the brain and the skin- addressing not only the psychological impact of living with a skin disease, but also how stress and stressful life events can trigger or exacerbate the condition. Our group is world-leading in efforts to unravel this complex relationship, and this issue of the Newsletter provides an overview of current work in this area.

It is recognised that people living with psoriasis have increased rates of depression and anxiety. Manchester’s IMPACT (Investigation and Management of Psoriasis Associated ComorbiTy) programme of research views the management of psoriasis as treating the whole person. Its objective is to improve the quality of care for people with psoriasis, particularly in primary care. We include an update on IMPACT and its contribution to The Psoriasis Association’s General Meeting for 2012. I am pleased to welcome Sara Wilson to the team as my Personal Assistant, and would like to recognise the invaluable support provided by both Sara and Carol Sewell (Research Secretary) that ensures the smooth administration of the unit. The team will be out in the community over the summer months, talking about skin health and the importance of sun safety. We are also looking forward to The Science Spectacular this autumn as part of the Manchester Science Festival (27th October at Whitworth Hall) - see you there!

Professor Chris Griffiths

03

The impact of living with a chronic skin condition can be wide reaching. The stigma associated with the disease, embarrassment surrounding the condition, and the commitment of trying out various treatment options can all weigh heavily on the mind of the patient. According to Professor Chris Griffiths, this is certainly the case for many people living with psoriasis- a common skin disorder that affects approximately 1.2 million people in the UK. Psoriasis patients may experience difficulties in social interactions- especially in meeting new individuals and forming romantic relationships. “Psoriasis can be very distressing, and can have a major impact on an individual’s quality of life. For this reason the condition should never be dismissed as ‘just a skin disease’”.

Manchester skin research is world leading in furthering understanding of the ‘brain-skin axis’- a term used to describe the interactions between the mind, immune system and inflammation of the skin.

Dr Elise Kleyn (Senior Clinical Lecturer at The University of Manchester and Consultant Dermatologist at Salford Royal NHS Foundation Trust) has made the ’brain-skin axis’ the focus of her research. She agrees that living with psoriasis can be stressful. “The fear of other people’s reactions to your psoriasis may cause anxiety, worry, depression, and a tendency to avoid situations that trigger a negative reaction” says Dr Kleyn. “That can make the management of certain skin conditions all the more challenging”.

Dr Hamish Hunter , Clinical Research Fellow (pictured below), is also focused on the brain-skin axis.

Dr Hunter explains that stress isn’t just a by-product of psoriasis- it can also be a trigger for the onset of the condition...

Dr Hunter became intrigued by the stress/skin relationship as a result of his experiences in dermatology clinics. “Many patients note that their condition worsens during periods of stress or anxiety. This is something you hear across the board in dermatology, and is not pigeonholed to one condition”.

Eczema, for example, is known to be associated with psychological stress. Research has shown that both children and adults with the condition have higher anxiety levels than those without, and it is well documented that psychological stress brings on attacks or exacerbates skin symptoms

The skin’s wound healing response has also been found to be affected by stress. A study conducted in the US demonstrated that individuals who had caring responsibilities (e.g. for an elderly family member) had a slower rate of skin healing compared to other people.

Another study (also conducted in the US), investigated medical, dental and pharmacy students during their final examinations- a period of high stress. It was found that the student’s skin responded differently to the repeated stripping of cellophane tape on their forearms, when compared to a period of ‘low stress’ (immediately on returning from holiday). The researchers concluded that stress had a negative effect on certain functions of the skin- effects which would reduce the skin’s ability to repair itself after injury. They also noted that the students involved had no pre-existing skin conditions, and suspected that people with eczema or psoriasis would have been even more adversely affected.

The skin disease best known as stress associated, and by far the most intensively studies for this association is psoriasis, with an estimated 40-60% of cases triggered by stress.

Many psoriasis patients consider stress to be the main cause of exacerbation of their psoriasis, ranking it above infections, trauma, medications, diet or weather. Dr Hunter explains the extent of the brain-skin relationship in psoriasis- “As psoriasis can cause considerable stress for patients, and increased levels of stress are likely to exacerbate psoriasis, the disease process becomes a self-perpetuating, vicious cycle” (Fig.1)

Professor Griffiths also notes that stress may not only worsen the severity of psoriasis, but it can also impact on the response of patients to the treatment of their disease. “It has been shown that patients with chronic plaque psoriasis, who are classed as ‘high’ worriers, are less likely than their ‘low’ worry counterparts to respond to PUVA therapy. If they do clear, it can take almost twice as long to achieve this.“

These studies appear to support what doctors have reported anecdotally for many years- that psychological stress can adversely affect the functions of the skin. However, how much is known about the science behind this relationship?

Feature

Although the exact mechanisms are not yet fully understood, it seems that the brain and the skin communicate in both directions using our nervous and immune systems, along with our hormones. There is evidence to suggest that susceptibility to exacerbation, or even the occurrence of psoriasis, may be the result of a maladaptive response to psychological stress.

The normal response to stress involves the production of a hormone called Cortisol. It is believed that the production of this hormone in some way protects the individual experiencing the stress. This excess cortisol may explain why acne patients report flares in times of stress. According to Dr Hunter, “elevated levels of this hormone may increase the skin’s oil production, making a person prone to pimples.” A study by the Manchester group however, has shown that people with psoriasis do not produce the same amount of cortisol during periods of acute stress. In fact, those patients who reported that their psoriasis was highly ‘stress responsive’ had even lower levels of the hormone.

The production and release of cortisol is controlled by the interactions of different organs of the body (located both in the brain and near the kidneys) referred to as the Hypothalamus- Pituitary-adrenal (HPA) axis. “Research such as the above suggests that patients with psoriasis, in particular those whose disease appears to be stress-associated, exhibit an altered HPA response” says Dr Kleyn.

Professor Griffiths and Dr Kleyn have also investigated the role specific cells play in the stress response. “Langerhans’ cells play an important role in the skin immune system” explains Dr Kleyn. “Their job is to detect early ‘danger signals’ and to alert other cells- such as those located in the skin’s lymph nodes. Our research has found that in healthy volunteers some Langerhans cells ‘migrate’ from the epidermis of the skin in response to stress- they move from the top layers of our skin to the lymph glands”.

Dr Hamish Hunter is working under the supervision of Professor Griffiths and Dr Kleyn to find out more. “We are building upon this previous work to investigate if Langerhans’ cells behave differently in people with psoriasis. Our other study has a slightly different emphasis. Using brain scanning techniques, we aim to explore the relationship between the skin and brain inflammation in people both with and without psoriasis.”

The Brain-Skin Connection

Not just a ‘skin disease’

“The influence of stressful life events on conditions such as psoriasis is clearly an important part of the picture” says Dr Hunter. For skin conditions like psoriasis, Dr Hunter believes that breaking this stress cycle may be an important part of any therapeutic approach. “It is important that clinicians address more than just the visible signs and symptoms. It has been shown that when the stress itself is also treated (for example through Cognitive Behaviour Therapy), the skin often clears quicker as the influences of stress are reduced”.

Although the association between stress and skin disease has been known for decades, the mechanisms underlying this reciprocal relationship has only just begun to be discovered. According to Professor Chris Griffiths, “Further exploration of the brain-skin axis may have far reaching implications for the future management of chronic inflammatory skin disease”.

Does how you feel on the inside affect how you look on the outside?

It has long been recognised that living with a chronic skin condition can have a significant impact on an individual. The daily grind of coping with a diagnosis of eczema, or psoriasis, can

be stressful, and has the potential to affect every aspect of a person’s life. However, there is now increasing recognition that the mind and the skin are even further entwined. An emerging body of evidence suggests that stress itself can trigger the development of some skin diseases,

or at least play a contributing role to a condition’s exacerbation.

Here we begin to explore the fascinating relationship between stress and the skin, and its importance in the management of skin conditions such as psoriasis.

04














Feature








Fig.1 - The stress-psoriasis relationship: a viscious cycle

(figure reproduced courtesy of Dr Hunter).

05














Feature






How does stress get under the skin?



Implications of the stress-skin relationship

Dr Elise Kleyn, Senior Lecturer at

The University of Manchester, and Consultant

Dermatologist at Salford Royal NHS Foundation Trust

06

As Professor Chris Griffiths’ PA, I am always very busy! My role is varied, and includes managing Professor Griffiths’ diary, organising meetings and liaising with senior staff at The University and Salford Royal Foundation Trust. It is my responsibility to ensure that Chris is kept updated with all developments, and that visits from visiting academics or industry representatives are a success.

I only joined the dermatology team earlier this year, but have worked alongside Chris before in our roles at Manchester Academic Health Science Centre (MAHSC). Prior to my posts at the University, I worked at Alliance & Leicester at Manchester Business Centre, where I was the PA to the regional director.

I used to enjoy volunteering with the National Trust, but since the birth of my little boy 16 months ago, I have found that most of my time is now accounted for!

Sara Wilson (PA to Professor Chris Griffiths)

I have been Professor Griffiths’ research secretary since 2007. My job is very diverse, but the bit I enjoy the most is arranging his travel. This is never straightforward and can be anywhere in the world- I enjoy the challenge! I also provide secretarial support for Dr Warren.

Before joining the group I worked as a PA for Professor Kimber at Syngenta- a large agribusiness firm. I was there for over 21 years.

In my spare time I am a Pampered Chef consultant, and enjoy gardening and keeping fit. I am married and have a 7 year old daughter who keeps me on my toes. I recently completed a 50 mile bike ride to raise money for my local church- along with my 71year old father!

Carol Sewell (Research Secretary)














SPOTLIGHT








Version 1: 01/08/2011

Ethics #11/NW/0574

Stress & the skina study aimed at understanding the critical role of stress in psoriasis

PARTICIPANTS REQUIRED Volunteers with psoriasis or no history of skin disease required. Participants will need to provide skin biopsies, a blood test and saliva samples.

THE DERMATOLOGY CENTRE, THE UNIVERSITY OF MANCHESTER

SALFORD ROYAL NHS FOUNDATION TRUST

For further information contact:

Dr. Hamish Hunter or Dr. Elise Kleyn

tel: 0161-206-4282

[email protected]

08

?

BSID Manchester group’s research celebrated at dermatology conference

The British Society for Investigative Dermatology (BSID) held their annual conference at The University of Exeter 16th-18th April. Established in 1982 as a registered charity, The BSID aims to promote high quality scientific research in dermatology. This is achieved principally through annual meetings of both scientists and clinicians, which include presentations of original research and guest lectures.

Researchers from Manchester featured heavily on this year’s programme. The group’s Dr Rachel Watson (one of our senior skin scientists) delivered an exceptional guest lecture on the subject of ‘photoageing’- a term used by scientists to describe the ageing affect of the sun on the skin.

Our clinical researchers also contributed at the conference, with Dr Stephanie Ogden presenting her work on specialised skin cells, called Langerhans’ cells. Dr Ogden summarised her investigations into how these cells behave differently as we age. Dr Phil Laws

BSID

presented in the same session on, ‘biomarkers of cardiovascular disease in psoriasis’. This was an interesting discussion of the association between cardiovascular disease and the skin condition.

The BSID is particularly keen to encourage the involvement of young scientists and clinicians, and junior researchers were given the opportunity at the conference to discuss their research with leaders in their field. An informal atmosphere was created in a novel ‘Meet the Committee’ session, to promote the relaxed discussion of cutting edge research.

Our Clinical Research Fellow Dr Amy Foulkes attended the event and believes that this support of early career researchers is essential. She found that the BSID conference, ‘facilitated discussions about research ideas and techniques that are key to the development of a new generation of researchers’.

Members of the Manchester team in Exeter

09 Ask an Expert

What are the worst and best things you can do to keep your skin healthy?

Excessive exposure to the sun is the fastest way to cause premature wrinkles, irregular pigmentation and an uneven skin tone. Smoking is also bad for your skin- the repetitive facial movements made as a person puffs away on a cigarette can, over time, lead to permanent wrinkles or “smoker’s lines” around the mouth. Furthermore, like UV exposure, smoking also creates free radicals which cause damage and reduces skin’s firmness and elasticity by attacking collagen.

The best thing you can do for your skin is to wear a good sunscreen. It is also important to eat a balanced diet rich in fresh fruits and vegetables for their anti-oxidant activity, in order to keep your skin healthy.

Dr Tamara Griffiths

Should I avoid the sun to protect myself from skin cancer, or should I sunbathe to make sure I get enough Vitamin D? I’m confused!

The link between skin cancer and the sun is well documented. A lot of research is still being conducted about Vitamin D production, and there are still many questions to be answered. We do know that Vitamin D helps to keep our bones healthy, and may even be involved in the prevention of several diseases. It is also true that sunlight helps our body produce this vitamin. However, according to The British Association of Dermatologists, the time needed

in the sun for our bodies to produce vitamin D is typically short. Therefore enjoying the sun safely, while taking care not to burn, can help produce sufficient levels of vitamin D without unduly raising the risk of skin cancer. It is also possible to increase levels of vitamin D through your diet- by example eating fatty fish, such as tuna or salmon.


I am concerned about a mole. What should I do?

Cancerous moles or melanomas are curable if caught early. The British Association of Dermatologists (BAD) recommend that everyone checks their skin regularly- at least once a month. There is some good information on how to check your skin using the ‘ABCDEasy’ method on the BAD and NHS Choices websites.

You should tell your doctor immediately about any changes to a mole or patch of skin. Your doctor can refer you to a Consultant Dermatologist.


I’ve loved sun bathing all my life. Surely there is no point in changing my behaviour now?

There’s always time to change! Research has shown that treatments such as retinoids will improve the appearance of wrinkles, but if you stop treatment and keep sunbathing, the wrinkles will return...

Dr Rachel Watson

My mother has excellent skin. Will this mean I will also stay looking younger for longer?

Our genetic makeup can influence how we react to our environment, for example the sun, and in the long term may influence how we wrinkle. This means that our behaviours (such as sun bathing and smoking) can also have a significant impact upon the rate at which we age. Unlike the fine lines and wrinkles we develop naturally, chronic exposure to the sun leads to deep wrinkles and a coarse texture of the skin. This means that you can still run into problems if you do not protect your skin!

Dr Rachel Watson

What should I look for when buying sunscreen?

Choose a broad spectrum sunscreen that protects the skin from both UVA and UVB rays.

Sunscreens in the UK are labelled with both a ‘SPF’ value and a star rating. SPF stands for ‘Sun Protection Factor’, and indicates the level of protection against UVB rays. These are the rays that cause sunburn- and sunscreens with a high SPF factor will prevent skin burning and the damage associated with skin cancer.

Select a sunscreen that also protects against the sun’s UVA rays. These rays penetrate deeper into the skin, and can even travel through window glass. A sunscreen with a high ‘star’ rating will defend the skin from UVA rays which can cause premature ageing and potentially skin cancer.

However, even when wearing sunscreen, some UV rays will still be absorbed by the skin. It is therefore also important to follow the other ‘top tips’ of sun safety- for example, keep out of direct sunlight between 11am and 3pm and stick to the shade.

Dr Tamara Griffiths

Ask an expert...

We’ve put together a selection of the common questions we get asked when out and about!

How much sunscreen should I apply, and when should I apply it?

Most people do not apply as much sunscreen as they should! As a rough guide The British Association of Dermatologists suggest a minimum of 6 full tea spoons to cover an adult body. If in doubt, apply more, and remember to cover all areas of the skin exposed to the sun – that includes the back of the neck and behind the ears! Sunscreen should be applied about 30 minutes before going out into the sun and should be topped up every 2 hours- and always after swimming.

Dr Tamara Griffiths

Is psoriasis contagious?

Psoriasis is a chronic skin condition that affects over 1.2 million people in the UK. It is believed to occur as a result of an abnormal inflammatory response in the skin. Psoriasis is not contagious- it cannot be passed from one person to another. It also does not ‘spread’ from one area of the body to another.

Dr Richard Warren

If I have psoriasis, will this mean that my child will also develop psoriasis?

About a third of patients have a family history of psoriasis, but it is also very possible that your child will not develop this disease. Psoriasis is a complex genetic disorder- there is no single ‘psoriasis gene’ that leads to the development of the condition. A person may need to inherit a certain mix of genes to be susceptible, followed by some sort of trigger- such as an infection- that activates the disease. Stress and alcohol are also factors known to exacerbate psoriasis.

For more information and support on living with psoriasis, contact the psoriasis association www.psoriasis-association.org.uk/ or visit www.psoriasis360.com

Dr Richard Warren

10

?Ask an Expert

What are the worst and best things you can do to keep your skin healthy?

Excessive exposure to the sun is the fastest way to cause premature wrinkles, irregular pigmentation and an uneven skin tone. Smoking is also bad for your skin- the repetitive facial movements made as a person puffs away on a cigarette can, over time, lead to permanent wrinkles or “smoker’s lines” around the mouth. Furthermore, like UV exposure, smoking also creates free radicals which cause damage and reduces skin’s firmness and elasticity by attacking collagen.

The best thing you can do for your skin is to wear a good sunscreen. It is also important to eat a balanced diet rich in fresh fruits and vegetables for their anti-oxidant activity, in order to keep your skin healthy.

Dr Tamara Griffiths

Should I avoid the sun to protect myself from skin cancer, or should I sunbathe to make sure I get enough Vitamin D? I’m confused!

The link between skin cancer and the sun is well documented. A lot of research is still being conducted about Vitamin D production, and there are still many questions to be answered. We do know that Vitamin D helps to keep our bones healthy, and may even be involved in the prevention of several diseases. It is also true that sunlight helps our body produce this vitamin. However, according to The British Association of Dermatologists, the time needed

in the sun for our bodies to produce vitamin D is typically short. Therefore enjoying the sun safely, while taking care not to burn, can help produce sufficient levels of vitamin D without unduly raising the risk of skin cancer. It is also possible to increase levels of vitamin D through your diet- by example eating fatty fish, such as tuna or salmon.


I am concerned about a mole. What should I do?

Cancerous moles or melanomas are curable if caught early. The British Association of Dermatologists (BAD) recommend that everyone checks their skin regularly- at least once a month. There is some good information on how to check your skin using the ‘ABCDEasy’ method on the BAD and NHS Choices websites.

You should tell your doctor immediately about any changes to a mole or patch of skin. Your doctor can refer you to a Consultant Dermatologist.


I’ve loved sun bathing all my life. Surely there is no point in changing my behaviour now?

There’s always time to change! Research has shown that treatments such as retinoids will improve the appearance of wrinkles, but if you stop treatment and keep sunbathing, the wrinkles will return...

Dr Rachel Watson

My mother has excellent skin. Will this mean I will also stay looking younger for longer?

Our genetic makeup can influence how we react to our environment, for example the sun, and in the long term may influence how we wrinkle. This means that our behaviours (such as sun bathing and smoking) can also have a significant impact upon the rate at which we age. Unlike the fine lines and wrinkles we develop naturally, chronic exposure to the sun leads to deep wrinkles and a coarse texture of the skin. This means that you can still run into problems if you do not protect your skin!

Dr Rachel Watson

What should I look for when buying sunscreen?

Choose a broad spectrum sunscreen that protects the skin from both UVA and UVB rays.

Sunscreens in the UK are labelled with both a ‘SPF’ value and a star rating. SPF stands for ‘Sun Protection Factor’, and indicates the level of protection against UVB rays. These are the rays that cause sunburn- and sunscreens with a high SPF factor will prevent skin burning and the damage associated with skin cancer.

Select a sunscreen that also protects against the sun’s UVA rays. These rays penetrate deeper into the skin, and can even travel through window glass. A sunscreen with a high ‘star’ rating will defend the skin from UVA rays which can cause premature ageing and potentially skin cancer.

However, even when wearing sunscreen, some UV rays will still be absorbed by the skin. It is therefore also important to follow the other ‘top tips’ of sun safety- for example, keep out of direct sunlight between 11am and 3pm and stick to the shade.

Dr Tamara Griffiths

How much sunscreen should I apply, and when should I apply it?

Most people do not apply as much sunscreen as they should! As a rough guide The British Association of Dermatologists suggest a minimum of 6 full tea spoons to cover an adult body. If in doubt, apply more, and remember to cover all areas of the skin exposed to the sun – that includes the back of the neck and behind the ears! Sunscreen should be applied about 30 minutes before going out into the sun and should be topped up every 2 hours- and always after swimming.

Dr Tamara Griffiths

Is psoriasis contagious?

Psoriasis is a chronic skin condition that affects over 1.2 million people in the UK. It is believed to occur as a result of an abnormal inflammatory response in the skin. Psoriasis is not contagious- it cannot be passed from one person to another. It also does not ‘spread’ from one area of the body to another.

Dr Richard Warren

If I have psoriasis, will this mean that my child will also develop psoriasis?

About a third of patients have a family history of psoriasis, but it is also very possible that your child will not develop this disease. Psoriasis is a complex genetic disorder- there is no single ‘psoriasis gene’ that leads to the development of the condition. A person may need to inherit a certain mix of genes to be susceptible, followed by some sort of trigger- such as an infection- that activates the disease. Stress and alcohol are also factors known to exacerbate psoriasis.

For more information and support on living with psoriasis, contact the psoriasis association www.psoriasis-association.org.uk/ or visit www.psoriasis360.com

Dr Richard Warren

La Roche-Posay is proud to be supporting the Mole and Sun Advice Roadshow this year in conjunction with the British Association of Dermatologists.

The Mole & Sun Advice Roadshow organised by the British Association of Dermatology (BAD), the UK’s leading skin cancer experts and supported by La Roche-Posay, is the UK’s biggest skin cancer awareness tour to date.The Roadshow, which aims to provide free mole and sun protection advice from leading consultant dermatologists, as well as free sunscreen samples to consumers, is visiting major festivals and events throughout

the UK this summer.

With skin cancer incidences continuing to rise in the UK and over 100,000 people being newly diagnosed every year, it is now the fastest rising cancer in young people aged between 15 to 24. The 2012 Mole & Sun Advice Roadshow aims to make people aware of skin cancer risks and how to enjoy the sun safely. Through practical, face-to-face demonstrations and engagement with the public the Mole & Sun Advice Roadshow hopes to encourage people to check their skin, seek the appropriate form of UV sun protection from their pharmacist,

and go to their GP if they notice any changes to their skin.

Our final Roadshow event is the Edinburgh Fringe Festival from 29th August to 2nd September.

SERIOUS ABOUT SUN PROTECTIONSERIOUS ABOUT SUN PROTECTION

ABOUT SUN PROTECTIONABOUT SUN PROTECTION

MY SUN ADVICE APP

La Roche-Posay have launched a sun care awareness iPhone application. This is aimed to help raise awareness of the need for daily use sun protection and the skin damaging effects of UVA & UVB rays.

> Works out a recommended

skin protection regime

> Provides daily information

on UV warning levels

> Highlights the latest

weather forecast in the UK

> Provides links to help find

the nearest 5 pharmacies

that stock La Roche-

Posay Anthelios

XL sunscreen.SEARCH

LA ROCHE-POSAY TO DOWNLOAD

IT NOW!

Time and expenses will be reimbursed.

For further information contact: Gill Aaronstel: 0161-206-1043email: [email protected] or visit: www.medicine.manchester.ac.uk/skin

THE DERMATOLOGY CENTRE, THE UNIVERSITY OF MANCHESTER

SALFORD ROYAL NHS FOUNDATION TRUST

aged 55+ years

Involves clinic visits and skin biopsies

volunteers Required for Skin Research

Version 1: 02/04/2012

Ethics: urec 12065

We were delighted to support such a novel event. Alongside The British Heart Foundation and St John’s Ambulance, we were invited to hold an information stand in the foyer area of St. Peters Chaplaincy on Thursday 14th June. Our aim was to raise awareness of sun safety, and to share top tips on how to keep skin safe in the sun.

Courtesy of La Roche-Posay, we had a range of sunscreens available to encourage people to top up their sun protection- very handy as the Manchester sun was out in full force on the day! Our clinicians manned the stall to answer skin care questions, and even brought along our VISIA imaging booth.

The VISIA system captures digital images of an individual’s face, and can analyse several different skin features -including wrinkles! It can even provide a comparison of your results to 1000’s of other people of the same sex, age and skin type. As usual our booth proved very popular as members of University staff queued for a mini skin consultation. We find the booth especially useful to illustrate the affects of sun damage, as the VISIA can show ‘UV spots’. These spots occur when the pigment melanin accumulates just below the skin’s surface. This happens as a result of sun damage. These UV spots may not be visible under normal lighting, but can be detected by the VISIA...

The University hosted their first Health and Safety Engagement Week this June. Aiming to promote the wellbeing of both staff and students, a number of fun activities were planned across the whole University campus. With an emphasis on ‘learning through fun’, activities included live demonstrations by Greater Manchester Fire and Rescue Service, visits to Jodrell Bank and even Abseiling!

Two senior members of staff were amongst a number of brave souls who took part in an abseil down University Place as part of the week, which also aimed to raise money for the British Heart Foundation.

David Barker, Head of Compliance and Risk at the University, was feeling confident about the descent down the 100ft wall of University Place as he has experience of abseiling as well as cave diving and explained: “I quite like to do unusual activities like this.”

Russell Ashworth, Head of Faculty Administration for Humanities, had never abseiled before the event and was “slightly apprehensive,” however, having successfully reached the ground, said that it was great fun and he would definitely do it again.

David summed up today’s event by stating that “abseiling is an apparently hazardous activity, but with the support of appropriately trained individuals you can get middle aged men to jump off tall buildings for a good cause.”

What’s Russell’s secret to a successful abseil? “Don’t look down!”

14




FEATURE







Health and Safety Engagement Week 11th-15th June 2012

15




FEATURE







Sun Safety Stall

(top) Dr Hunter and Dr Ali. (bottom) Memebers of the team assist a representative from St John’s Ambulance to try our VISA.

16




FEATURE







A comparison of ‘surface spots’ (visible to naked eye) to UV spots (characteristic of sun damage) using the VISIA imaging booth.

Look out for our VISIA atour sun awareness events in

Manchester throughout the summer!

17 FEATURE

Some sunshine can be good for you as it helps the body to produce vitamin D, but taking a few steps when out and about in the summer sun or when on a sunshine holiday will help to protect you from sunburn and the risk of skin cancer, particularly if you are pale skinned.

• Protect the skin with clothing, including a hat, T shirt and UV protective sunglasses.

• Spend time in the shade between 11am and 3pm when it’s sunny.

• Use a sunscreen of at least SPF 30 (SPF 50 for children or people with pale skin) which also has high UVA protection. • Keep babies and young children out of direct sunlight.

• The British Association of Dermatologists recommends that you tell your doctor about any changes to a mole – if your GP is concerned about your skin, make sure you see a Consultant Dermatologist (on the GMC register of specialists), the most expert person to diagnose a skin cancer. Your GP can refer you via the NHS.

• Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection.

Text reproduced with permission from The British Association of Dermatologists (www.bad.org.uk)

Top sun safety tips from the British Association of Dermatologists

18FEATURE

Professor Chris Griffiths consults on cutting edge documentary.

In this episode of the long running science programme, Plastic surgeon Dr Rozina Ali leaves the operating theatre behind to ask if it is possible to make your skin look younger without surgery.

She discovers the latest research about how the foods we eat can protect our skin from damage and how a chemical found in a squid’s eye is at the forefront of a new sun protection cream.

Professor Griffiths is featured discussing the effects of sun damage on the skin. Assisted by our Research Technician Lindsay Cotterell, Professor Griffiths used our VISIA imaging booth to demonstrate the impact UVA rays have had on the skin of two volunteer lorry drivers- and on the face of presenter Dr Ali herself!

Much to Dr Ali’s dismay, all three had evidence of ‘lopsided’ ageing. Each had more wrinkles developing on one side of their face than the other-, showing the effects of extra hours of sun exposure whilst driving. Professor Griffiths explains that although a vehicle’s windscreen protects us from UVB rays (and therefore burning), damaging UVA rays can penetrate glass.

‘The Truth About Looking Young’ is available to download on BBC iPlayer until September.

19

? The IMPACT programme of research (Identification and Management of Psoriasis Associated Comorbidity) is

based in Manchester and led by Principle Investigator Professor Chris

Griffiths . Awarded a £2million National Institute of Health Research grant, the project will last five years and aims to

improve the care of people with psoriasis. The team have been in touch

to keep us updated...

UPDATE

20

Dr Pauline Nelson

Dr Lis Cordingley

UPDATE

We are pleased to report on a very successful IMPACT input into the Psoriasis Association Annual Conference held at Whittlebury Hall, Northamptonshire on 12th May 2012. The Psoriasis Association (PA) is the leading national charity and membership organisation for people affected by Psoriasis in the UK.

IMPACT team members Dr Lis Cordingley (Senior Lecturer in Health Psychology) and Dr Pauline Nelson (Research Associate) presented at the conference to an audience of PA members, trustees, dermatologists and specialist nurses. Pauline gave an overview of the IMPACT programme- emphasising the role of patients and the PA's input in all aspects of the research. Pauline also presented key points from a specific aspect of the programme, ‘Workstream 3’. Through detailed interviews, this part of the research aims to learn from patients about they cope with their skin condition.

Lis followed up with a session on stress and coping in long-term conditions. Both sessions were interactive, involving audience participation through the use of ‘traffic light’ coloured cards. This was something everyone seemed to enjoy! This interactive exercise also enabled us to see how well our findings resonated with the audience’s own experiences.

Both sessions received very positive feedback. Chair of the Psoriasis Association, Professor Ray Jobling, thanked Pauline and Lis, and concluded by saying how delighted the PA trustees were to be associated with such a prestigious research team.

Lis joined the closing session of the conference, an “Ask the Expert” panel, together with Dr Sandy McBride

(Consultant Dermatologist at the Royal Free in London) and Julie van Onselen (Dermatology Specialist Nurse at Oxfordshire PCT Dermatology Clinic). Delegates submitted questions for discussion and topics included:

• Once psoriasis has been treated with topical medication, how can patients eliminate markings on the skin?

• How long can steroid topical treatments be used for?

• Why are joint clinics so rare, and what is the benefit of having a psychologist in a joint clinic?

• Do the benefits of sun exposure for psoriasis outweigh the risks of melanoma?

• Will the cost of biologic treatments come down so as to be available to more patients?

• In terms of co-morbidities that may be linked to psoriasis, which professionals are responsible for monitoring patients? Is there no system in place currently, and should patients be more proactive?

• The importance of language used when discussing psoriasis. Most delegates preferred the neutral term ‘condition’ rather than ‘disorder’, ‘complaint’, ‘disease’ or ‘illness’.

We had letters of appreciation and thanks from the Psoriasis Association following our input to the conference.

Follow the IMPACT team on Twitter @impactpsoriasis to keep up-to-date with all IMPACT news! We can also be

contacted via our website www.impactpsoriasis.org.uk

If you just have a question you’d like to ask please use the ‘contact us’ form.

21

?UNIT NEWS

News in brief

Skin expert battles elements to raise money for charity

The team’s Dr Tamara Griffiths took part in the 2012 Greater Manchester Marathon this Easter to raise money for the British Skin Foundation.

The marathon returned to Manchester on 29th April after a 10 year break, and was Dr Griffiths’ first charity run.

“As a dermatologist, I see on a daily basis how debilitating skin disease can affect peoples' lives. It crosses all age ranges, from babies and children to the very old, and can have profound and life-ruining consequences. The British Skin Foundation funds high quality research, which translates into improved patient care and hope for those who suffer from skin disease.”

Our skin expert battled horrendous weather conditions on the day to complete the 26.2 mile course, and managed to raise over £1,600 for the charity. “Donations have continued to come in which is fantastic- I think people felt sorry for me battling the freezing rain and bitter north-easterly winds!”

To make a donation to Tamara’s appeal, visit VirginMoneyGiving.com and search Tamara Griffiths.

Tamara has not been our only clinician to pull on her running shoes for a good cause...

Dr Amy Foulkes completed the BUPA Great Manchester run back in May in aid of Guide Dogs for the Blind.

Amy was inspired to raise money after witnessing the difference the charity made to the life of her grandmother. “The ability to get around is vital in order to live a full life, yet thousands of blind and partially sighted people find it difficult to leave home alone. Guide Dogs empower visually impaired people to do that, but relies solely on the support of the public to fund the guide dog service.” Amy was in good company on the day- the BUPA run had in excess of 33,000 runners, among which were many celebrity participants including Jeff Hordley (Actor-Emmerdale), Nell McAndrew (model), Peter Hook (bass player- New Order/Joy division) and Anthony Cotton (Actor- Coronation Street).

Dr. Tamara Griffiths in training

Dr. Amy Foulkes completing the 10k course.

To make a donation to Amy’s appeal, visit her JustGiving site http://www.justgiving.com/Amy-Foulkes

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Dr Stephanie Ogden, Clinical Research Fellow

And finally... The 92nd British Association of Dermatologists conference was held this year in Birmingham, 3rd to 5th July 2012, and was attended by over 1,300 UK and worldwide dermatologists and specialist nurses.

Contributions from the Manchester team included presentations from Dr Tamara Griffiths (Common Skin Conditions:Acne and cosmetic dermatology), Dr Hamish Hunter (Stress & psoriasis – a historical perspective) and Dr Elina Theos (Clinical and Immunologi-cal aspects of late onset psoriasis).

Manchester Science Festival is a nine day programme of events, giving you the opportunity to meet some of the UK’s top scientists. Now in it’s sixth year, you can expect the festival to be packed with lots of fun events to keep everyone busy during half-term!

Dermatology research will be once again joining the festival’s biggest event- the ‘Science Spectacular’. Packed with exciting hands-on activities for all the family, last year’s highlights included drunken fruit flies and making edible cells!

We would love to see you at our ‘Secrets of the Skin’ stall at the spectacular - to be held in Whitworth Hall on Saturday 27th October 2012.

For more information visit http://www.manchestersciencefestival.com/

UNIT NEWS

Manchester Medical Society’s Clinical Research Prize 2012 has been awarded to Dr Stephanie Ogden (Clinical Research Fellow). Presented annually, the prestigious prize is given in recognition of outstanding research work conducted by a clinical trainee. In April Dr Ogden became the 22nd recipient of the award for her ‘Investigation of Langerhans’ cell Function in Aged Skin’. Dr Ogden remarked, ‘I enjoyed the opportunity to present my research and obviously was thrilled to win the prize.’ Previous recipients of the award include the group’s Dr Elise Kleyn, who received the award in 2007 for her work on stress and the skin.

Manchester Science Festival – 27th October- 4th November

Jean Bastrilles

0161 2064282

[email protected]

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