Yale's Christopher Bunick new skin treatment helps patients see 'transformative results'

A potential breakthrough in treating congenital ichthyosis offers hope for sufferers like 12-year-old Peyton Fleagle, as a new ointment developed by Timber Pharmaceuticals has shown promising results in clinical trials conducted at Yale School of Medicine.

Peyton Fleagle was a toddler when his parents noticed the symptoms of congenital ichthyosis, a disfiguring skin condition that affects children characterized by dry, scaly patches. The diseases hinder the skin's regenerative process, leading to the accumulation of dry, scaly patches across the body. There is no FDA-approved treatment for ichthyosis, but the new treatment targets retinoic acid receptors within the nucleus of skin cells, effectively normalizing the turnover of skin cells and reducing the retention of old cells, according to a release by Yale News. 

Christina Fleagle, Peyton's mother, shared her joy about the treatment, saying, "It was like magic. His skin completely cleared up. All the scales were gone," she said.

The research at Yale is led by Christopher Bunick, an associate professor of dermatology at Yale School of Medicine. Bunick expressed optimism about the ointment's effectiveness.

"Several of my patients have seen transformative results, where their scale is entirely clear, the skin clear for the first time," he said. "It is remarkable." The phase two clinical trials at Yale, a critical step before potential FDA approval, involved studying the safety, tolerability, and efficacy of the new medicine on patients. The first study, featured in the Journal of the American Academy of Dermatology evaluated two concentration levels of the ointment, with both concentrations deemed safe, while the lower concentration demonstrated superior efficacy. 

The second study involved 33 patients and assessed the effectiveness of the treatment using two primary measures - the Visual Index for Ichthyosis Severity (VIIS) scale system and the Investigator Global Assessment (IGA) score. Patients who received a 0.05% concentration of the treatment experienced a 50% reduction in VIIS and two or more levels of improvement in IGA. The most recent study, accepted by the journal Clinical and Experimental Dermatology, examined the ointment's effectiveness in treating two specific types of congenital ichthyosis - lamellar ichthyosis and X-linked recessive ichthyosis. The results were encouraging, with all patients meeting the VIIS and IGA goals.

Bunick highlighted Yale's crucial role as the only U.S. site involved in all three trials, underscoring the university's longstanding prominence in ichthyosis research. 

"From a young age, patients must endure chronic fissured and scaly skin, often red and inflamed as well, making them targets for jokes or bullying at school," he said. "These patients are always 'different' due to their appearance," adding that the new ointment has brought relief and hope, easing Peyton's discomfort.