Getting under the skin

Eevery year since its founding in 2008, the Asia Pacific branch of Fondation La Roche-Posay has granted awards for winning research in dermatology. This year the prestigious prize in the clinical research category has gone to Thai doctor Dr Jane Areejanawat, whose work on the prevalence of the autologous serum skin test (ASST) and autologous plasma skin test (APST) positivity in patients with chronic spontaneous urticaria has earned her US$5,000.

“The money will be of significant help to my research,” says Dr Jane. 

Chronic urticaria – a form of skin allergy – is defined as urticaria that persists for more than six weeks. While 20 per cent of CSU cases develop from various triggers such as temperature, heat and pressure on the skin, it is believed that 80 per cent or more are related to an autoimmune cause.

Dr Jane is interested in major autoimmune urticaria, which can be confirmed or otherwise by a serum or plasma skin test. And while talking with the patient is still recognised as the most important diagnostic tool, using the appropriate test will help the doctor find the exact cause of the chronic disease that dramatically affects quality of life.

Her research aims to help the dermatologist make a decision on which of the two tests is more effective,

Since its debut in 2008, the Foundation has focused mainly on in-depth molecular research with prizes going to China, Korea, Japan and Taiwan. Dr Jane is the first Thai winner.

“Here is Thailand, we don’t have the facilities for such in-depth research as it requires high levels of funding and a certified laboratory,” says Dr Noppadol Noppakun, president of the Thailand Dermatology Society as well as of the Asia Pacific Fondation La Roche-Posay.

To encourage dermatologists in other countries who don’t have the potential for detailed research to take part in the annual competition, Dr Noppadol convinced the foundation to add more awards for clinical research. This allowed Dr Jane to submit her findings based on a case study of some 60 patients from all over Thailand.

“We have a lot of patients to provide the data for clinical research” he says.

Dr Noppadol says that it’s important for doctors to do research in their field as a way of improving diagnosis and treatment, adding that he also asked La Roche Posay Thailand to give three awards for outstanding research by Thai dermatologists.

“The recognition and prize money will encourage our doctors to work in research. Often they have to fund this out of their own pockets and with only minimal support from their office,” he says.

Another winner this year is Dr Vasanop Vachiramon of the Ramathibodi Laser Centre, Division of Dermatology at Ramathibodi Hospital.

His research focused on Low-fluence Q-switched Nd: Yag 1064-nm laser and intense pulsed light (IPL) for the treatment of melasma. His findings have been published in the respected journal of the European Academy of Dermatology and Venereology.

Dr Vasanop compared the efficacy and safety of combined LFQS and IPL on 20 female patients with mixed-type melasma on both cheeks, treating them with LFQS on full face in five sessions at weekly intervals. One side of the face was randomly assigned to receive an additional three sessions of IPL treatments at two-week intervals and patients were evaluated 12 weeks after the last treatment. 

The results showed that the combination of LFQS and IPL resulted in faster clearance of melasma and was more effective than LFQS alone for melasma treatment. However, recurrence is still inevitable.

Both LFQS and IPL are popular treatments for melasma and the treatment protocol will serve as a guideline for those who are considering it.

Despite skin clinics having mushroomed all over Thailand in recent years, Dr Noppadol urges caution as only about 20 new dermatologists are approved each year. Thailand has only 550 certified dermatologists though another 1,000 doctors who have received some training are available for consultation at skin clinics and hospitals.