A Few Words
About our clinic
The Centre of Excellence for Atopic Dermatitis (COE AD) at the McGill University Health Centre (MUHC) is the first academic clinic in Canada dedicated to adult atopic dermatitis (AD). Commonly known as eczema or atopic eczema, AD is the most common and the most burdensome inflammatory skin disorder worldwide. Founded in 2018 by Dr. Carolyn Jack, the primary mission of the MUHC COE AD is to drive clinical excellence for chronic AD, centered on evidence-based and guideline-driven management. The clinic, a tertiary care site, is a referral center for dermatologists across Quebec, a training site for medical students, physician learners, and dermatology residents, and offers onsite consultation with multidisciplinary specialties (internal medicine, infectious disease, allergy and immunology, etc.), and allied health care providers within a polyclinic infrastructure.
The MUHC COE AD has been recognized nationally and internally for its unique patient engagement platform. Guided by CIHR’s Strategy for Patient-Oriented Research, the clinic's formal Patient Partner C. Bouchard co-directs patient engagement. The clinic is also the first Canadian site to be accredited by the Global Allergy and Asthma European Network (GA²LEN) Atopic Dermatitis Centers of Reference and Excellence (ADCARE). Click here to learn more via the GA²LEN website.
GA²LEN was created to combat fragmentation in the European research area, ensuring excellence in EU allergy and asthma research by bringing together institutions and researchers from across the EU. The network notably put in place centralized structures and an office overseeing the multiple assets in knowledge in the different GA²LEN partners, enabling them to optimally synchronize their research efforts.
This academic initiative was started at McGill University under the leadership of two experts in "Skin allergy" or Patch testing (Dr. Denis Sasseville, Dr.Linda Moreau) who assigned Dr. Carolyn Jack to lead a sub-committee on Atopic Dermatitis.
Dr. Jack is an Assistant Professor of Dermatology at McGill University, and leads Quality and Innovation for the Division. She trains students and scientists within the Infectious Diseases and Immunity in Global Health Program and Center for Translational Biolology of the Research Institute of the McGill University Health Centre (RI-MUHC).
The clinic is home to the largest number of adult AD patients in Canada who participate in patient-oriented quality improvement and research activities with international stakeholders. As the first Canadian accredited site of the international ADCARE consortium, the MUHC COE AD was audited by GA²LEN, a European Union-based quality management (QM) framework to address the problem of differing standards of care for patients with allergies, asthma, and atopic dermatitis. The GA²LEN ADCARE Quality Management Program aims to solve the problem of fragmented or differing standards of care for allergy and asthma patients. This is the first and only QM program to use a set of quality criteria to certify 'Atopy' (Allergy, Asthma, Atopic Dermatitis, Allergic Rhinitis, Eosinophilic Esophagitis) Centres in the same way that other QM programmes certify, e.g. standards of care in Cancer centres, or general standards in medical facilities.
The MUHC COE AD's vision is to reduce the burden of atopic dermatitis and other atopic diseases by improving the health of patients by accelerating the application of results from fundamental research into clinical practice and quality of care, and to promote training and greater integration between public and academic sectors.
MUHC COE AD Team
Dr. Carolyn Jack
MDCM, PhD, FRCPC
Founder, MUHC COE AD
Assistant Professor, McGill University
Divisional Lead in Quality and Innovation
Division of Dermatology, Medicine
McGill University Health Center-Glen
Investigator, Infectious Diseases and Immunity in Global Health Program, Research Institute-MUHC
Co-Founder, Director, Eczéma Québec
Junior Research Assistant – Recruitor, CTTB - Centre for Translational Biology
MUHC COE AD
MUHC COE AD Multidisciplinary Atopy Board and Network
- MUHC Glen Otolaryngology
Surgery (Dr. Tewfik)
- MUHC Glen Respiratory
Medicine (Dr. Olivenstein, Dr. Cormier)
- MUHC Pediatric Allergy & Immunology
Allergy & Immunology (Dr. McCusker, Mazer, Dr. Ben-Shoshan)
Pediatric Dermatology (Dr. Miedzybrodzki)
- MUHC Adult Allergy & Immunology
Medicine (Dr. Fein, Dr. Alizadehfar, Dr. Tardio)
- MUHC Glen D2 Multidisciplinary Polyclinic
Allergy & Immunology
Gastroenterology, Hepatology, Transplantation
Infectious Diseases, Tropical Medicine
- MUHC MGH Patch Testing
Dermatology Adult (Dr. Nigen)
Dr. Jack's Research
Dr. Jack's research program aims to address the simple but unanswered question, "Why does atopic dermatitis persist and what does Staphylococcus aureus bacteria have to do with it?" As an FRQS Clinicial Research Scholar (click here to learn more), Dr. Jack leads the only dedicated university-based atopic dermatitis research program in Canada, with a fundamental wet lab located at the Research Institute of the MUHC, adjacent to her clinic. Dr. Jack's research program works to connect stakeholders and to value patients' experience and knowledge about their disease, alongside expert clinicians and researchers.
Why is this research needed?
Atopic dermatitis is not only the most common but also the most burdensome skin disorder in the world, and is strongly connected to asthma and allergies. Suffering with AD throughout life is now known to be common, and adults often have a harder time getting treated, more severe skin inflammation, and more changes to blood immune cells. The reasons why are unclear, but one-tenth of adults develop AD late in life, so environmental factors may play a large role. Evidence for such culprits is strongest for the bacteria Staphylococcus aureus (staph). Commonly found in our noses, staph can cause serious infections; in AD skin, it is usually present. More staph growth associates with more severe disease and coincides with flares. We don't understand how this bacterium interacts with the skin immune system in AD; this, together with missing information on genetic factors, needs substantial research. We know that some populations and peoples seem to be more at risk, and Dr. Jack's team is exploring the role of ethnicity, skin of colour, and Indigenous health in this disease.
Collaborative research teams with broad expertise and integrating patient experience and knowledge are needed when considering resistance to treatment. To that end, Dr. Jack leads the Canadian Patient-Oriented Dermatitis Database and Biobank (C-POD). Funded by a 2022 SkIN Canada Team Development Grant, this team has the largest Canadian adult AD database and biobank, and aims to share specimens, protocols, and management infrastructure, along with digital tools. The aim of C-POD is to work together to promote long-term remission of disease.
Dr. Jack's is also the lead laboratory for the Canadian Atopic Dermatitis Cohort for Translational Immunology and imaging (CACTI). Funded by a Canadian Dermatology Foundation Team Grants Competition for Th2 Inflammatory Skin Diseases, this multi-university, pan-Canadian collaboration is the largest prospective observational study of adult AD in the country. We have little evidence to select between some of the older treatments that are available now. Even the newest targeted therapy does not clear most patients’ skin. In order to improve our understanding of AD, how to treat it now, and to enable discovery of new treatments, the CACTI team enrolls patients into a large study at three sites across Canada (University of Toronto, McGill University and University of British Columbia). Data is collected on how severe patients’ AD is, what treatments they use, and, for patients who consent, blood and skin biopsy samples are collected to study the mechanisms underlying their disease. The CACTI team also tests to see which form of phototherapy works best for AD, and uses advanced imaging techniques to visualize the skin. This collaboration has begun to fill knowledge gaps for AD, and beyond answering the specific questions of this grant, the CACTI team is empowered to do even more work in the future, building capacity as a national team of dedicated clinician scientists.
Jack lab, RI-MUHC