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Dr John Ingram

Dr John Ingram

Clinical Senior Lecturer

School of Medicine

Improving the care of people with hidradenitis suppurativa is my principal research and clinical focus within dermatology. Hidradenitis suppurativa (HS) is a neglected, painful chronic inflammatory skin disease, characterised by recurrent skin boils in flexural sites, producing a large impact on quality of life and affecting about 1% of the adult European population.

Currently I am Chief Investigator of the HTA-funded THESEUS study and I am a co-founder and Steering Committee member of HISTORIC, the core outcome domains global collaboration for HS. Previously I led several HS research consortia, including the Cochrane Review of Interventions for HS, James Lind Alliance HS Priority Setting Partnership and the British Association of Dermatologists HS Guideline Development Group. My aim is to conduct HS randomised controlled trials to improve patient outcomes. I run one of the few dedicated HS clinics in the UK and champion a multi-disciplinary team approach to HS care.

In terms of international roles, I am Editor-in-Chief of the British Journal of Dermatology (https://onlinelibrary.wiley.com/journal/13652133), ranked 3rd out of the 66 dermatology journals.

Education & Qualifications

FRCP(Derm) Medicine Royal College of Physicians 2017
FAcadMEd Medical Education Academy of Medical Educators 2014
MSc Medical Education Cardiff University 2012
Certificate of Completion of Training Dermatology General Medical Council 2011
DM (Oxon) Medicine Oxford University 2008
MA Physiological Science Oxford University 2004
MRCP (UK) Medicine Royal College of Physicians 2002
BM BCh Medicine Oxford University 1999
BA Physiological Science Oxford University 1996
       
       

Career Overview

My present appointment is Senior Clinical Lecturer, Cardiff University & Honorary Consultant Dermatologist, Cardiff & Vale University Health Board (2013 - present).

Previously I trained in dermatology on the South Wales Training Rotation and worked for 12 months in dermatology and general medicine in Australia. I performed my DM doctoral studies in Cardiff after completing my SHO medical rotation in South Wales and undertook all of my undergraduate medical training at Oxford University.

Professional memberships

Grant Advisory Committees

  • British Skin Foundation Large Grant Advisory Committee member 2013-18
  • HCRW Research for Patient and Public Benefit Grant Funding Board member 2016-17

Examination Boards

  • Royal College of Physicians Dermatology Specialty Certificate Examination Board member 2013-18

UK Advisory Roles

  • British Association of Dermatologists (BAD) representative for NICE STA of adalimumab for hidradenitis suppurativa
  • NICE Evidence Resources Reference Panel member - dual RCP & BAD representative
  • Medical Adviser for Hidradenitis Suppurativa Trust, the main HS charity in the UK
  • Performed External Review of St John’s Hidradenitis Suppurativa clinical service at the request of Guy’s and St Thomas’ NHS Foundation Trust 2017
  • Lead for British Association of Dermatologists HS Guideline Development Group 2015-19
  • UK Department of Work & Pensions Adviser regarding HS disability

UK Dermatology Clinical Trials Network (UK DCTN)

  • Steering Committee member
  • Chair of Trial Generation and Prioritisation Panel (TGPP) 2014-18

All Wales Roles

  • Health and Care Research Wales Dermatology Lead

Speaking engagements

2020

  • European HS Foundation annual meeting. "What patient reported outcomes do we really need?" Athens

2019

  • World Congress of Dermatology "Syndromic hidradenitis suppurativa." Milan
  • European Academy of Dermatology and Veneorology Annual meeting. Invited speaker at journal editors’ session: “BJD Editor’s Pick.” Madrid
  • Symposium on Hidradenitis Suppurativa Advances "THESEUS study to evaluate new outcomes for HS " Detroit

2018

  • UK Dermatology Clinical Trials Network Evidence Based Update meeting. “HS Guidelines from the BAD.” Nottingham, UK.
  • Symposium on Hidradenitis Suppurativa Advances. “UK guidelines for HS Management.” Toronto.

2017

  • SID Annual Meeting Residents Retreat. Invited speaker: “Publishing a manuscript.” Portland, Oregon.
  • British Association of Dermatologists Annual Meeting. Invited speaker and session chair. “Biologic Interventions for Hidradenitis Suppurativa.” Liverpool, UK 2017.

2020

2019

2018

2017

2016

2015

2014

2013

2012

2011

2010

2009

2008

2005

Medical undergraduates

  • Admissions interviewer
  • Dermatology clinical tutor
  • Academic mentor
  • Finals ISCE examiner

Dermatology postgraduates

  • Lecturer and examiner for Diploma & MSc in Clinical Dermatology
  • Lecturer for MSc course and intercalated BSc medical undergraduate course in Medical Education
  • Lead for Diploma in Practical Dermatology 2012–14. In this role I modularised the course, blueprinted assessments to level 7 learning outcomes and moved the Virtual Learning Environment to the Cardiff University Blackboard provider

Hidradenitis suppurativa

My main research interest is hidradenitis suppurativa (HS), a relatively common, painful chronic inflammatory skin condition which can have a large impact on quality of life and may be difficult to treat. As a result, more than 50 medical and surgical interventions have been tried and our Cochrane review showed that the evidence base for most interventions is relatively poor, making treatment decisions challenging. I recently led the British Association of Dermatologists HS Guidelines Development Group which published the first UK guidelines for HS in 2019.

I am building the foundations to perform rigorous clinical trials to improve the care of people with HS. Our HS Priority Setting Partnership between HS patients and clinicians (http://www.jla.nihr.ac.uk/priority-setting-partnerships/hidradenitis-suppurativa) highlighted the therapy areas that are most in need of more evidence. My five year Health Fellowship from Health and Care Research Wales (2014-19) demonstrated that HS is a relatively common condition, affecting about 1% of the UK population, highlighting the unmet need to improve HS care.

I am also a member of the European Reference Network for skin diseases (ERN-Skin) regarding HS (https://ern-skin.eu/thematic-groups/thematic-group-hidradenitis-suppurativa-related-syndromes/)

HISTORIC

My systematic review of the outcome measure instruments used in HS randomised controlled trials found substantial heterogeneity with 30 instruments used in 12 trials. This limits meta-analysis and comparison between trials, preventing truly evidence-based decisions informing patient care. As a consequence I co-founded HISTORIC, the HS Core Outcomes Set International Collaboration, supported by the Core Outcomes in Effectiveness Trials Initiative (COMET), Core Outcomes Set Initiative of the Cochrane Skin Group (CS-COUSIN) and the International Dermatology Outcome Measures (IDEOM) organisation. The HISTORIC group includes a 50:50 balance of HS patients and healthcare professionals from 19 countries in 4 continents. Six core outcome domains, the 'what' to measure in HS clinical trials were agreed: pain, physical signs, HS specific quality of life, global assessment, progression of course and symptoms. They are designed for use in all future HS clinical trials globally. The next step is to validate an instrument to measure each domain.

THESEUS

I am Chief Investigator of THESEUS, a HTA-funded prospective observational cohort study investigating five treatments for HS with 12 months' follow up:

  • doxycycline 200mg daily
  • clindamycin and rifampicin both 300mg twice daily
  • laser treatment
  • deroofing
  • conventional surgery

The THESEUS study website provides a decision grid and deroofing videos for patients and health care professionals: https://www.cardiff.ac.uk/centre-for-trials-research/research/studies-and-trials/view/theseus 

Research Students

  • Dr Faraz Ali, PhD programme
  • Dr Zahra Ahmed, PhD programme
  • Dr Samar Hasan, PhD programme
  • Rubina Shah, PhD programme