Dr John Pauling

For this Specialist Chat we talk to Dr John Pauling, Consultant Rheumatologist at the Royal National Hospital for Rheumatic Diseases and Senior Lecturer in the Department of Pharmacy & Pharmacology about early diagnosis in scleroderma. The interview questions are below;

  1. Please could you give us a brief description of your role and how you're involved with people with scleroderma.
  2. There are 19,000 people diagnosed with scleroderma in the UK, but it is thought many more are still un-diagnosed, mainly due to lack of awareness in the public and health practice. This can potentially be fatal.
  3. Could you explain briefly what scleroderma is, the main symptoms, or what people should look out for, and what to do if they're worried.
  4. At SRUK we're working on raising awareness of scleroderma to improve diagnosis and hopefully improve life outcomes for people and families affected. Can you explain why it's important to get an early diagnosis, or what the outcomes are likely to be for someone with an earlier diagnosis as opposed to a later diagnosis and treatment of 3 years and more.
  5. Could you give us a brief description of what the referral process would be and what tests would be taken. Then again briefly describe what to look out for and what to do if people are worried.

If you have any questions for John you can email livechat@sruk.co.uk

John qualified from Nottingham University Medical School in 2002. After completing General Medical training, he commenced Specialty Training in Rheumatology in 2005. He developed a clinical interest in the Connective Tissue Diseases early in his specialty training, particularly in relation to Raynaud's phenomenon and systemic sclerosis; a rare multisystem disease of unknown aetiology characterised by vasculopathy, fibrosis and autoimmunity.

In 2009 he was awarded the Dando fellowship, jointly funded by the RSA and Royal College of Physicians. His PhD research, undertaken under the supervision of Professor Neil McHugh at the University of Bath, evaluated the potential contribution of platelets to microvascular dysfunction in primary Raynaud's phenomenon (RP) and systemic sclerosis (SSc). This work has helped John to develop an interest in outcome measures in SSc research, particularly in relation to peripheral microvascular dysfunction in scleroderma. John has interests in non-invasive methods of measuring tissue perfusion such as infra-red thermography and laser-derived imaging modalities. He has undertaken early validation studies of laser speckle contrast imaging (LSCI) in RP and SSc. He is interested in the relationship between peripheral microcirculatory function and circulating vascular biomarkers.

John also leads the RNHRD Rheumatoid Arthritis service and has developed an interest in predictors of treatment response to biologics in rheumatoid arthritis (RA). Dr Pauling is working with the British Society of Rheumatology Biologics Register (BSR-BR) to identify factors influencing treatment responses to biologic therapy in RA.

John leads the microvascular imaging service at RNHRD and is a member of the EULAR Microcirculation study group. He is contributing to current initiatives of the UK Scleroderma Study Group and the Scleroderma Clinical Trials Consortium (SCTC). He co-chairs the SCTC Vascular Working Group that is currently working on developing better methods for assessing peripheral microvascular function in systemic sclerosis.