What does it mean to you to have won this award?
I feel very humbled to have been recognised in this way and to know that I have been able to make a small difference to our patients with infantile haemangiomas and those with severe atopic dermatitis in the UK and elsewhere.
Importantly, the work could not have been done without the support of many others, not just in the UK but also internationally, including collaborations with colleagues here at King’s and from the European Society of Pediatric Dermatology (ESPD), the US Pediatric Dermatology Research Alliance (PeDRA), the British Society of Paediatric and Adolescent Dermatology (BSPAD), and the European Dermatology Forum, the International League of Dermatological Societies (ILDS), the International Society of Atopic Dermatitis (ISAD), the International Eczema Council (IEC) and the World Health Organization (WHO). I would also like to thank our funders, in particular the UK National Institute for Health and Care Research (NIHR), who funded me through three consecutive personal fellowships (2009-2020) and the TREAT trial that underpins this award.
What’s next for you in this area?
Oral propranolol, a beta-blocker mainly used to treat high blood pressure, is now the most widely employed treatment for complex infantile haemangiomas, for instance when they threaten vision, bleed or ulcerate. In its generic form, it is a cheap medication and accessible even in low resource settings, in part through its listing in the WHO Essential Medicines List (EML).
We are now aiming for the same for methotrexate in atopic dermatitis. Having conducted international treatment surveys in Europe and North America, which informed the largest paediatric trial with methotrexate (vs ciclosporin) in children and young adults with severe atopic dermatitis, demonstrating the drug’s cost-effectiveness, I am now leading an International League of Dermatological Societies (ILDS) application for methotrexate to be included under this indication. At present, we have no systemic therapies for atopic dermatitis on the WHO EML.
What do you see as the strengths of our Faculty? What makes us distinctive?
I have been at King’s since 2009, and a key strength in the Faculty of Life Sciences and Medicine is our collaborative networks, all the way from basic laboratory research to clinical medicine. For instance, the work around methotrexate included Professor Leonie Taams (Head of the School of Immunology & Microbial Sciences). She and her team led on the mechanistic work embedded in the TREAT trial, helping us to understand the effects methotrexate has on skin barrier function and systemically.
What is a typical day like for you?
I am a clinical academic and enjoy seeing patients in my Paediatric Severe Eczema Clinic, my Paediatric Urticaria and Mastocytosis Clinic, as well as in the Combined Vascular Anomalies Service, all at St Thomas’ Hospital. Otherwise, I lead a team of 25 researchers undertaking a broad research programme mostly focused on atopic dermatitis, other inflammatory skin conditions and allergic diseases.
What do you think people in the Faculty would find most surprising about you?
That I lived in a Buddhist monastery in Taiwan during my gap year, have a degree in Chinese Studies, and completed my PhD in Vietnam at the Oxford University Clinical Research Unit, where I investigated whether gut parasites protect us against allergic diseases. They do!
What advice would you give to your 18-year-old self?
Watch out for opportunities, grasp them and don’t worry about choosing the ‘perfect’ path. I spent a year in China and then did Chinese Studies and Preclinical Medicine, before moving to Cambridge to do a Masters in History of Medicine and then went into clinical medicine in Oxford. Looking back, I don’t regret any of these experiences, even if the path didn’t quite fit into a conventional career track at the time.
Do you have any current projects that you’d like to tell us about?
I am particularly excited about our work on transcutaneous sensitisation to foods (TRANS-FOODS project), which is a collaboration with Stuart Jones (Pharmaceutical Medicine) and Alexandra Santos (Paediatric Allergy) as well as colleagues in France and Germany. We think we have worked out how food allergies develop through the skin, now considered the main route for food allergy development, and this opens up new opportunities for disease prevention in early life.
We are also working closely with the WHO and Global Burden of Disease study, as well as other international stakeholders in the Global Atopic Dermatitis Atlas (GADA) project, synthesising the data we have worldwide on the burden of atopic dermatitis and its links with comorbidities, but also conducting fieldwork in geographical areas where we currently have no data. We are also looking at the interactions between bacteria, fungi and the skin immune system, and the mind/brain-skin axis, as well as conducting clinical trials and national and international treatment registry work on severe inflammatory skin diseases.
What do you do with your time outside academia/work?
I am lucky to live in the South Downs National Park and enjoy walking in the stunning countryside surrounding our village. I have also contributed to our local drama society and play the Northumbrian pipes.
What are you most looking forward to in the next academic year?
A fieldtrip to Cebu in the Philippines, connecting with colleagues we are working with in the Global Atopic Dermatitis Atlas (GADA) project. We will be involved in a skin disease survey there.
Who inspires you most and why?
My PhD supervisor Professor Hywel Williams from Nottingham University and Professor David Strachan from St George’s London, the father of the hygiene hypothesis. I worked with both on the International Study of Asthma and Allergies in Childhood (ISAAC), the largest epidemiological study ever conducted in children (>1.3M). Their integrity as senior academics and global contributions to the fields of dermatology and allergy epidemiology and clinical science through non-commercial trials are a true inspiration.
What is your favourite thing about working at King’s?
Being surrounded by great colleagues, including my research and clinical teams, and being part of Europe’s leading clinical and research centre for cutaneous medicine, St John’s Institute of Dermatology.
What is your favourite part of your role?
That I can combine my research with seeing patients, with the opportunity to help improve their lives.
QUICK-FIRE:
Favourite season: Spring on a Cycladic island
Favourite book: The Magic Mountain by Thomas Mann
Favourite cuisine: Thai food
Coffee order: Vietnamese iced coffee with condensed milk