Author: catriona.rutter

It’s just over a year since the new Centre for Applied Excellence for Skin & Allergy Research (CAESAR) was established.  As centre lead, this is a chance for me to reflect on what’s been achieved in the first 12 months and what 2025 brings. 

CEASAR is part of my NIHR Research Professorship, which is a 5 year award I started in December 2023.  Although it is a personal award, what has been really exciting about getting it is all the other people I have been able to start working with because of it. 

Over previous years, I’ve worked with lots of dedicated and clever people, who have helped make studies like BEE and TIGER possible.  This includes the small army of people at the Bristol Trials Centre, who make clinical trials possible.  Clinical trials are usually the best way of finding out whether something is really helpful or not, be that a skin cream, food allergy test or something else. 

But not all research needs or is ready for a trial.  And how do we know which are the most important research questions to answer anyway? 

That’s why I’m so pleased that the National Institute for Health and Care Research (NIHR) decided to fund me, CAESAR, and the Transforming Outcomes for Paediatric allergy In primary Care (TOPIC) programme.  There are 5 main elements to TOPIC: 

• Two are about childhood eczema – finding out the best way to use emollients and topical steroids together and whether an eczema clinic in your GP surgery would help to treat the condition better. 

• Another two are about childhood food allergy – deciding what the research priorities are and looking into awareness of current guidance about introducing food allergens into infants’ diets. 

• The final one cuts across all of these – keeping the patient and public voice at the heart of what we do and how we do it. 

All this is only possible with the work of the 3 Research Fellows, Project Manager and Research Administrator, who do all the heavy lifting to deliver these projects.  They are supported by other colleagues who also help supervise 3 PhD students who are doing related work on food allergy and the treatment of eczema.  Patient charities have also joined us to help make our research as useful as possible. 

With all of the research team in place, CAESAR is now fully-sized, and we have our work cut out in the forthcoming year to seize the opportunities that have come with it.  We will continue to write blogs to keep you updated as each bit of research progresses but please get in touch if you would like to get involved or would like to receive our regular newsletter. 

Matthew Ridd, January 2025. 

The first survey of the PSP is now closed. We are analysing the responses and the second prioritizing survey is due to launch in April 2025.

1 in 5 children in the UK suffer from eczema. But what is the lived experience of eczema from a patient and parent perspective, and what are the challenges they face on a daily basis?  

My name is Dr. Eliza Hutchison and I am a resident Dermatologist and Academic Clinical Fellow and spend my academic time with Professor Matthew Ridd and the rest of the Centre for Applied Skin & Allergy Research (CAESAR) team. I attended an event organised by Eczema Outreach Support (EOS), a charity founded in 2011 that provides practical and emotional support for children and young people with eczema and their families. I went as part of the CAESAR team to raise awareness of our research, in particular the BEE (Best Emollients for Eczema) and TIGER (Trial of food allergy [IgE] tests for Eczema Relief) studies.  

The afternoon consisted of both child and parent-focussed activities. Whilst the children engaged in a relaxation session and various games, parents had the opportunity to attend a peer support session and a doctor-led question and answer session.  

It was a wonderful afternoon and provided valuable insight into eczema experiences from a patient and carer perspective. Families had travelled from across the UK to attend. Children were mostly accompanied by their mothers, but some fathers and grandparents also attended. Most children at the event had moderate to severe eczema.  

We joined a peer support session in which parents shared their experiences and challenges of having a child/young person with eczema. Conversation was focussed on delays and frustration around access to secondary care Dermatology services. Many parents felt that advice and treatments provided in primary care were unsatisfactory, and often described having to ‘fight’ to get help.  

There were many concerns around topical steroid safety and withdrawal and queries regarding how to wean steroids, as well as a desire to use more natural skin products. Many parents seemed to use a trial-and-error approach to treatments and purchased a lot themselves rather than via a prescription.  

Food allergies in eczema was another frequently raised topic. Many parents were concerned that food allergies were driving their child’s eczema and had tried omitting certain foods themselves but felt dismissed by their healthcare professional when they requested an allergy test. It was clear that eczema causes a significant emotional burden on both the child and their family, and in many instances it also created tension in parental relationships.  

I was surprised that research was not mentioned, both in terms of getting involved and the possibility that it may provide a solution to the common challenges faced by individuals. When we spoke to families about CAESAR and our work, many were not aware that they could get involved in research. We had a lot of interest in our current TIGER study on eczema and food allergy testing, which is currently recruiting. 

From a clinician’s point of view, it was particularly interesting to hear about eczema from a parental perspective and the impact it can have on the whole family. In clinic we often just get a snapshot of a child’s eczema experience and sometimes don’t appreciate the significant impact it can have on the rest of the family, such as on sleep, education, work and relationships. Furthermore, hearing about the significant concerns many parents have around topical steroid safety and the influence of food allergies was particularly interesting as sometimes as clinicians we can inadvertently dismiss these concerns without properly acknowledging them. Clearly further research is needed in these areas to better-understand their role in eczema.  

My takeaway points were: 

• Eczema can be a significant burden on the whole family, not just the eczema-sufferer; 

• Topical steroid safety and food allergies in eczema-sufferers are common concerns and parents/carers often feel dismissed when they raise these concerns to healthcare professionals;  

• Many parents/carers are not aware of current eczema research nor the possibility of getting involved, so we need to work closely with the patient community to broadcast research developments and opportunities.  

It was an eye-opening, informative afternoon and we enjoyed representing the CAESAR team. We look forward to attending similar events in the future.  

Do you have a food allergy or care for someone with food allergy? Do you have a question you would like answered by research? Tell us to help set the TOP 10 research priorities for food allergy in children!

Our first survey is now open – click here to take part and shape future research!

 

As Allergy Awareness Week comes to an end, we are very excited to share the announcement that came out yesterday introducing the Centre for Applied Excellence in Skin and Allergy Research. Read more about it here.