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New mobile app helps eczema sufferers track their itch

SINGAPORE — An eczema sufferer for the last 38 years, Madam Zaleha Abdul Kader used to get stressed and easily frustrated. But when the photographer, who declined to reveal her age, began using a mobile app to track her skin condition, her quality of life significantly improved. She now gets reminders to moisturise, which helps cut down on her itch and flaky skin.

Portrait of (left) National Skin Centre Adjunct Professor Steven Thng and Dr Yew Yik Weng, taken at National Skin Centre on August 20, 2018.

Portrait of (left) National Skin Centre Adjunct Professor Steven Thng and Dr Yew Yik Weng, taken at National Skin Centre on August 20, 2018.

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SINGAPORE — An eczema sufferer for the last 38 years, Madam Zaleha Abdul Kader used to get stressed and easily frustrated.

But when the photographer, who declined to reveal her age, began using a mobile app to track her skin condition, her quality of life significantly improved. She now gets reminders to moisturise, which helps cut down on her itch and flaky skin.

“I can jot down or enter my eczema situation daily, and there will be reminders or prompts for me to moisturise. As you know, we tend to ‘forget’ (to do that),” she said.

The first-of-its-kind app, called Taggle Eczema, was the brainchild of Adjunct Professor Steven Thng from the National Skin Centre (NSC).

Inspired by similar apps for weight loss where users can track their food intake and exercise regimens, the senior consultant dermatologist told TODAY he wanted to find out if eczema sufferers could better manage their condition if they had a tool to monitor their treatment.

“The idea of empowering patients is very new and interesting. Asian patients are very dependent on their doctor … but if you think very logically, how does visiting a doctor monthly really improve you if you need a daily treatment?” said Dr Thng, who heads the pigment clinic at NSC.

Characterised by itchiness and red, inflamed skin, eczema is the top skin condition seen at the NSC, which receives an average of 500 new patients in its eczema clinic every year.

The Taggle Eczema app works by having users rate their eczema, itch and sleep scores on a scale of zero to 10 every day. They also track the number of times they moisturise, apply topical steroid cream or take their pills on the app. Photo: Koh Mui Fong/TODAY

One in five children and one in 10 adults in Singapore suffer from the chronic inflammatory skin disorder. Dr Yew Yik Weng, consultant-in-charge of the eczema clinic, said that the majority of patients seen at the clinic are of school-going age.

Three-quarters of the NSC’s eczema clinic’s patients have mild to moderate eczema, while the rest suffer from the moderate to severe form of the condition, which means it affects their daily quality of life.

There is currently no cure for eczema, but maintenance treatments of daily moisturising can keep it under control.

The Taggle Eczema app works by having users rate their eczema, itch and sleep scores on a scale of zero to 10 every day. They also track the number of times they moisturise, apply topical steroid cream or take their pills on the app.

Through an inbuilt algorithm devised by the doctors, the app gives certain recommendations based on the information the user has entered. In turn, users can then make changes to their treatment plan, such as how frequently they take their medication.

The app also leverages information about the weather to give users tips. If someone is in New Delhi, India during the summer time when it is hot and polluted, for instance, the app will pull data from its central weather station and tell him to moisturise more times than usual.

Patients can also show their doctors the information they have tracked on their app, which will give doctors a better sense of their daily regimen.

For instance, if a user slept well the previous night and did not scratch himself, he might not need to take his antihistamines the next night, Dr Thng explained.

“While we track and monitor, we wanted to find out: Can we now adjust the patients’ medication based on all these parameters?” he added. “What is common in the clinical setting is that we tell patients to take this medicine when it’s itchy, apply this cream if it’s worse … but patients do not know what it means by ‘as and when required’.”

Because of this, some people stop applying their topical steroid cream before their inflammation fully comes down, he said.

The advice both doctors have for eczema sufferers is to apply the cream “as early as possible” in the beginning stages of their disease, so they can get better within a few days and only need to moisturise regularly.

“The interesting thing is that a lot of people are steroid phobic,” Dr Thng noted. “They apply a bit (of cream) and get only half better, then they stop applying, thinking it’ll make things worse. Then everything relapses again.”

Dr Yew added: “You should really kill the fire right at the start, make sure everything is put out, so that it won’t come back the moment you stop applying.”

Twenty-eight NSC patients are currently undergoing user trials with the app.

Currently available in the Apple and Android app stores, the free app will be officially launched at the NSC’s Eczema Public Forum on Oct 27.

Following that, the doctors plan to conduct clinical trials. They also plan to develop wearable sensors for users in the future.

These sensors will capture more accurate information on the patient’s micro-environment — for example, if they are in an air-conditioned room — and provide more targeted recommendations.

Developed free-of-charge by community health gaming platform Taggle, the app took about two years to be fine-tuned. The doctors plan to further tweak the game element in the app to make it more interactive.

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