NIHR/BAD Research Taster Bursary Report

NIHR/BAD Research Taster Bursary Report

Centre for Evidence-based Dermatology

I am very grateful to the NIHR/BAD for the wonderful opportunity to spend time at the Centre for Evidence-Based Dermatology(CEBD) at the University of Nottingham where I was supported by Professor Hywel Williams together with Prof IoanNotingher and Radu Boiter. I was invited to chose a specific research project that particularly interested me and enthusiastically I chose the Raman spectral imaging project. On day one, I was welcomed into the Physics laboratory by Professor Notingher and RaduBoiter where I was introduced to the concept of Raman spectroscopy and itspotential todetect residual basal cell carcinoma (BCC) at the time of surgical excision.

Raman Spectroscopy offers the ability tomeasure endogenous molecular differences between BCC and healthy skin tissue. BCCsare usually removed by wide local excision then sent for histopathology which creates considerable waiting timebetween excision and BCC diagnostic confirmation.If inadequate marginsare determined, then this could lead to the possibility of a further procedure. The development of Raman spectroscopy could mean fast and objective detection of tumour at the time of excision while promoting tissue conserving surgery and decreasing the need for a second procedure. I was given the opportunity to utilize this instrument and learnt first hand how this could impact clinical practice within the field of Dermatology. Using specimens obtained during MOHS micrographic surgery, RaduBoiter and I applied a multitude of different settings to ascertain which would combine to create reproducible accurate results as compared to the H&E histology specimens.

I was then introduced to the full team at the CEBD and was fortunate to have a one-on-one meeting with Professor Williams, co-director and founder of the CEBD. He provided invaluable advice and encouraged me to be more systematic in my approach to research as well as broaden my knowledge with respects to statistics. He was able to explain the difference between validity and repeatability using a rugby analogy which not only made me laugh but the concept will never be forgotten. With his guidance I completed a protocol for an inter-operator variability study for the Raman instrument.

I was fortunate to meet Dr Simpson who explained her PhD in vulval erosive lichen planus and met with Dr Batchelor who is the lead on the HI-Light Vitiligo trial. They both detailed their lives in the field of research giving me excellent pointers to excel in this career which was greatly insightful. Interacting with these passionate individuals opened my eyes to the fact that research in Dermatology can be very rewarding. The possibility of providing the answers to questions that have been asked by so many patients and doctorswas enough to convince me to pursue a career in Dermatology research.

I also attended a teleconference with Professor Thomas about the BEE (Best Emollient for Eczema) Trial. This shed light on the intricacies involved in being a principal investigator and setting up such a large individually randomized trial. Later, I had the opportunity to attend the Queen’s MedicalCentre spending a morning in Professor William’s Paediatric clinic. Seeing patients with relatively rare conditions like EpidermolyticIchythosis andChildhood Granulomatous Periorificial Dermatitis was very interesting. It was apparent that there were many children with difficult to manage atopic eczema whose quality of life was severely affected by their conditions.

Overall my taster week provided insight into cutting edge research with the Raman Spectrometerwhich we are likely to see and use in the future. I had the opportunity to write a protocol for an inter-operator variability study and have since revisited the University of Nottingham to participate in inter-user studies. We have recently submitted a research paper for publication following on from this. I thoroughly enjoyed my Taser Research week. It was an absolute privilege to visit the CEBD and I would like to thank them for supporting me on my research path.