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Pediatric Eczema and Scratch Sensors with Steve Xu, MD, MSc

Atopic dermatitis — or eczema — affects about 10 million children in the U.S., and the itching that accompanies this condition can cause pain and distress for kids who can't always verbalize or quantify how much they're suffering. But a new wearable sensor developed by Northwestern University scientists could help better monitor scratching and assess the effectiveness of therapies for eczema and other conditions that cause itch. Steve Xu, MD, MSc, talks about the wearable sensor and the critical role it could play in bringing much-needed relief to patients.


Steve Xu

"Just like we measure blood glucose or hemoglobin A1C for patients with diabetes, just like we measure blood pressure for patients with hypertension, I think that measuring scratching for patients that have atopic dermatitis can represent that level of transformation."

— Shuai (Steve) Xu, MD, MSc

Episode Notes

Steve Xu, MD, Msc, is a physician-scientist-engineer who spends much of his time at Northwestern in the translation of breakthrough electrical engineering, materials science and health information technology to address major unmet clinical needs. He is the lead author of a recent study published in Science Advances that details how a soft, wearable sensor developed by Northwestern University scientists was used to quantify itch in children with atopic dermatitis, also known as eczema.

With the device, clinicians and parents have the ability to track how well itch is being controlled in patients at home to monitor for treatment response as well as early signs of worsening disease. The sensor was accepted into the Food and Drug Administration’s Drug Development Tool program, which allows novel devices like this sensor to be qualified to aid in the approval of new drugs.

In the study, the overall accuracy of the device was 99 percent. "This is a pretty significant result and probably the most accurate, with the most number of patients reported, (using) these kinds of devices," Xu says. 

Other topics covered:

  • The hallmark symptom of atopic dermatitis is itch leading to sleep disturbance, poor neurocognitive development and, on average, a full night of sleep lost per week.
  • As a result of itch, patients with atopic dermatitis are 44 percent more likely to report suicidal thoughts compared to controls. The ability to quantify symptoms is important to help new drugs get approved, but also to improve patients' quality of life.
  • Although an individual's perception of itch via a survey or scale is important, Xu says, it isn't always possible for a 4-year-old or 5-year-old to verbalize or quantify their suffering.
  • Xu explains that the study was conducted in two parts. The first involved training the sensor to pick up scratching in healthy adults doing voluntary scratching behaviors. The second tested the sensors on pediatric patients with atopic dermatitis.
  • Parents set up an infrared camera to serve as the "gold standard." The algorithm and sensor were then used to count scratches in this pediatric patient population. More than 300 hours of sleep data were manually reviewed and scored for scratching and linked to the sensors.
  • Parents were the "heroes" of this study, Xu says. They were committed to obtaining objective data to understand how medications are working for their children.  
  • The team is also looking to use the technology for other conditions that cause itch such as kidney disease and psoriasis. 
Additional Reading: 
  • "Skin sensors are the future of health care" published in Nature
  • "Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units" published in Nature Medicine

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Recorded April 26, 2021.