Johan Anker Allerup

Atopic dermatitis – also knowns as childhood eczema – is very common: up to 20% of children experience a flare-up while growing up; in a small percentage of these, the symptoms will occasionally recur; and, in rare cases, this skin disorder will become a permanent affliction.

The risk of developing atopic dermatitis increases if there is a mutation of the gene that codes for filaggrin, one of the proteins that play a part in generating the skin’s outer layer, and, thus, in maintaining a protective barrier.
This mutation is relatively common. It is found in 5–10% of the European population.

However, science is still looking for answers to many of the questions regarding atopic dermatitis – one being which factors trigger an attack.

‘And it’s these triggers that I’ll be concentrating on during my DARE project,’ Johan Anker Allerup explains. Johan is 27 years old and is studying medicine at the University of Copenhagen. He has one year left before he graduates as a doctor.

‘I’ll be working with my American mentor, Justin Ko, who’s a clinical professor of dermatology at Stanford University,’ says Johan.

‘I’ll analyse the results of measurements of a range of environmental factors – from temperature to atmospheric humidity, UV radiation, air pollution and water hardness. And I’ll attempt to identify how these affect atopic dermatitis in a total of 3000 patients in the US and Denmark. In order to glean new knowledge from the huge volumes of data we collect, we need to use extremely sophisticated computer models – some based on artificial intelligence.’

The study requires a high degree of patient involvement: Johan Anker Allerup and his colleagues will post advertisements on Facebook and Google to recruit 2000–3000 patients with atopic dermatitis in the USA and around 250 in Denmark.

All patients who enrol will be informed about the study via video chat. Once they have consented to participate, they will be asked to provide information such as their age and any other illnesses.

Over the following three months, each participant will take a photograph of their eczema once a week and submit the photo. The images will be analysed by dermatologists who will then determine the severity of the condition.

Johan Anker Allerup explains that the 12 images will enable him to track the development of each patient’s atopic dermatitis throughout the period:

‘And each patient’s development will be compared with a wide range of meteorological and environmental measurements taken in the area where the patient lives. We’ll have access to relevant environmental monitoring stations in both the USA and Denmark, and among other things we’ll be able to see particulate pollution.’

When it comes to concluding on all the data, it may be relevant to investigate whether particulate pollutants from the extensive wildfires that ravage the western USA year after year perhaps have an impact on atopic dermatitis.

‘Some of the airborne risk factors we’re looking at are tiny particles emitted from, for instance, fires, wood-burning stoves and diesel cars. We’re also looking at carbon monoxide and nitrogen oxides,’ says Johan Anker Allerup.

‘One thing all of these risk factors have in common is that they’re local irritants – and they reduce the effect of the skin barrier function. Therefore, it’s relevant to track their levels over a period of time and compare them with the documentation of the severity of atopic dermatitis we see in the patients’ photos.’

Johan Anker Allerup’s Danish mentors are Dr Zarqa Ali, postdoc, and Professor Simon Francis Thomsen, both from the Department of Dermatology, Bispebjerg Hospital.