Non-Invasive, Precision-Based Approaches for Diagnosis and Treatment of Inflammatory Skin Conditions

 Michael D. Howell, Ph.D., Chief Scientific Officer of DermTech 

Inflammatory skin conditions such as atopic dermatitis, psoriasis, vitiligo, hidradenitis suppurativa and others impact a significant portion of the U.S. population. In fact, nearly half of all visits to primary care physicians include some level of dermatological indication. Many of these dermatologic conditions are accompanied by pain and severe discomfort for affected patients, and the resulting morbidity of the condition may have a negative impact on mental health, self-esteem and overall quality of life. 

As the prevalence of various inflammatory skin conditions grows, more non-invasive, precision-based approaches for diagnosis and treatment are critical for improving patients’ lives. 

Existing Methods of Diagnosis and Treatment

To diagnose most dermatological indications, physicians traditionally rely on the combination of visual assessment, a patient’s description of their symptoms and other disease-associated markers. For example, the presence of red, itchy lesions and increased allergen sensitivity is traditionally used by physicians to confer the diagnosis of atopic dermatitis. 

These evaluations are subjective to each physician’s own medical training, experience and opinion. In some instances, inflammatory skin diseases such as atopic dermatitis and psoriasis may present with similar symptoms and visual markers. These factors can make correctly identifying an inflammatory skin condition very difficult and outline the need for additional objective measures.

This traditional diagnostic process often leads to a trial-and-error treatment approach.  More specifically, under this approach, patients cycle through a list of therapeutics until they find one that works best for them.  While the armamentarium of approved therapies continues to grow, the therapeutic benefit for each one varies which leads to the cycling of therapies. The lack of appropriate treatment may be associated with an increased disease burden and/or financial impact. In some cases, administering the wrong therapeutic to the wrong patient can lead to a worsened condition, increased infections within the skin and even hospitalization.

Precision-based diagnostic and treatment approaches in dermatology may allow physicians to interpret skin conditions on a more granular level. We are seeing the tangible benefits it can have for both patients and physicians, and demand is increasing.

Benefits of Non-invasive Technology 

Many clinical trials in dermatology incorporate a skin sample collection to learn more about how therapy works in a skin disorder. While skin biopsies are considered the “gold standard” for many researchers, a host of challenges accompany this practice such as wound repair, skin infections and the general aversion to skin biopsies amongst patients. In fact, less than 20% of patients enrolled in dermatology-focused clinical trials typically volunteer to participate in optional skin biopsy collections. 

In contrast, non-invasive skin sampling is a highly attractive alternative to skin biopsies and can serve as a surrogate for biopsies. 

The Potential of Personalized Approaches

The integration of precision-based approaches is driving medicine toward continued innovation and development in dermatology. Furthermore, non-invasive, precision-based approaches to diagnosis and treatment will undoubtedly make medicine more personalized leading to improved outcomes and patient success. 

By understanding the underlying biology of common inflammatory skin conditions, diagnosis and treatment will become more objective and, therefore, more effective. 

About Michael Howell, Ph.D. & Chief Scientific Officer at DermTech

Michael Howell, Ph.D., is an immunologist with more than 20 years of experience in the government, academia, and the biopharma/biotech sectors. Prior to joining DermTech, Dr. Howell was a faculty member at National Jewish Health and held increasing positions of responsibility at Boehringer Ingelheim, MedImmune/AstraZeneca, and Incyte Corporation. Dr. Howell has previously led research and development teams dedicated to the discovery of novel therapies for dermatology and the integration of novel biomarker approaches including adhesive tape strips into clinical development. His efforts have led to the approval of multiple therapies, novel diagnostic approaches to patient treatment, and have been highlighted in more than 50 publications and numerous patents. Dr. Howell received his Ph.D. in Immunology from West Virginia University and completed his post-doctoral training at National Jewish Health