Physician's Profile: Active derm advocates for profession, collegues, patients

June 1, 2008

No one in his right mind would accuse Amy S. Paller, M.D., of sitting idly, letting life pass her by.

The clinician, educator, researcher, politician, editor, wife and mother has made significant contributions in every aspect of her life.

Dr. Paller is endowed professor and chair of dermatology and professor of pediatrics at Northwestern University Feinberg School of Medicine, Chicago.

"Many leaders in dermatology, and certainly in pediatric dermatology, have worked with me in the past, and I would hope that somehow I have influenced the fact that they are such contributors," Dr. Paller tells Dermatology Times.

Research: A passion

Dr. Paller traces her fascination with genetic disorders back to childhood. She kept a scrapbook of clippings from her parents' Time magazines, highlighting genetic abnormalities in the magazine's "Medicine" section.

Time spent doing graduate research at Brown University further fueled Dr. Paller's interest. She also spent a summer in Israel, working alongside an internationally known genetic specialist.

She runs a bench science lab, and her work in glycolipid biology keeps her interacting with scientists outside dermatology, while her collaborative research in determining the underlying basis for several genodermatoses immerses her in dermatology peers and genetic researchers.

Dr. Paller has published some 30 collaborative articles looking at the underlying basis of genetic disorders of the skin.

Among her many published studies was first-author paper with Dr. Elaine Fuchs in 1994 in the New England Journal of Medicine (NEJM).

Dr. Paller and the group clearly showed that mosaic skin disorders that follow lines of Blaschko result from mutations in genes that are expressed in the epidermis, with a perfect correlation between the patterning of abnormalities in the skin and the distribution of the mutated versus normal gene expression.

Dr. Paller has also been a clinical expert on other disorders that have an immune basis involving the skin, such as childhood psoriasis, atopic dermatitis, immunodeficiencies and collagen and vascular disorders in children.

As head of a clinical trials unit at Children's Memorial for about 15 years, Dr. Paller has been involved in more than 60 trials, covering the spectrum of common and rare pediatric dermatology disorders.

One of her recent studies published in NEJM was the first to test biologics for psoriasis in children. Dr. Paller and colleagues found that etanercept is efficacious in children, with children showing an excellent response at lower dosages than adults.

"I think the whole field of genetic disorders and what they can teach us is burgeoning. We have spent the last almost two decades understanding the basis for monogenic disorders. The excitement in this decade will be dissecting the genetic changes that underlie polygenic disorders, as well as understanding the role of localized mutations in mosaic disorders," she says.

"As both a bench scientist and a clinician, I particularly enjoy bringing the discoveries from the bench to the clinician using language that's understandable. So, I am able to bridge the gap between the bench and the clinical," she says.