Bio


Shivali started her role as a Postdoctoral Research Fellow at the Stanford University Department of Dermatology in September 2020. She grew up in Leicestershire, England. She graduated from Cardiff University School of Medicine in 2017, and has a BSc (Honours) in Medical Genetics. After graduation, she completed a two-year academic internship program with the University Hospitals of Leicester, England. Following this, she was selected for a national medical leadership fellowship and worked as an Editor at The BMJ from 2019-20. Whilst at medical school, she co-founded The British Student Doctor Journal, a novel peer-reviewed journal to educate and train medical students in editorial work, peer review and publishing. The journal is a publication of The Foundation for Medical Publishing, and Shivali now serves as an Executive Director and Trustee of this organization.

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  • A global, cross-sectional survey of patient-reported outcomes, disease burden, and quality of life in epidermolysis bullosa simplex. Orphanet journal of rare diseases So, J. Y., Fulchand, S., Wong, C. Y., Li, S., Nazaroff, J., Gorell, E. S., de Souza, M. P., Murrell, D. F., Teng, J. M., Chiou, A. S., Tang, J. Y. 2022; 17 (1): 270

    Abstract

    Epidermolysis bullosa simplex (EBS) comprises a group of rare, blistering genodermatoses. Prior work has been limited by small sample sizes, and much remains unexplored about the disease burden and health-related quality of life (QOL) of patients with EBS. The aim of this study was to characterize the most common patient-reported clinical manifestations and the health-related impact of QOL in EBS, and to examine differences in disease burden by age.Patients with a diagnosis of epidermolysis bullosa (EB) or their caregivers completed a one-time online survey administered by EBCare, an international online EB registry. Survey data from respondents self-reporting a diagnosis of EBS were analyzed for clinical and wound manifestations, medication use, and QOL (using Quality of Life in Epidermolysis Bullosa [QOLEB] scores). Differences across age groups were assessed using Kruskal-Wallis and Fisher's exact tests.There were 214 survey respondents with EBS. The mean age was 32.8 years (standard deviation = 19.2). Many respondents reported blisters (93%), recurrent wounds (89%), pain (74%), chronic wounds (59%), itch (55%), and difficulty walking (44%). Mean QOLEB score was 14.7 (standard deviation = 7.5) indicating a "moderate" impact on QOL, and 12% of respondents required regular use of opiates. Findings were consistent in subgroup analyses restricted to respondents with diagnostic confirmation via genetic testing or skin biopsy (n = 63 of 214). Age-stratified analyses revealed differences in disease burden: younger respondents were more likely to self-report severe disease (24% vs. 19% vs. 5% for respondents aged 0-9 vs. 10-17 vs. 18 + , p = 0.001), failure to thrive (9% vs. 15% vs. 3%, p = 0.02), and use of gastrostomy tubes (15% vs. 12% vs. 1%, p < 0.001) and topical antibiotics (67% vs. 69% vs. 34%, p < 0.001), while older respondents were more likely to be overweight or obese (6% vs. 0% vs. 51%, p < 0.001) and have difficulty walking (24% vs. 46% vs. 48%, p = 0.04).In the largest international cross-sectional survey of EBS patients conducted, respondents reported extensive disease burden including significant wounding, pain, itch, difficulty walking, and impact on QOL. Age stratified disease manifestations. These findings suggest significant unmet need, and treatment and counseling for EBS patients should consider age-specific differences.

    View details for DOI 10.1186/s13023-022-02433-3

    View details for PubMedID 35841105

  • Patient-reported outcomes and quality of life in dominant dystrophic epidermolysis bullosa: A global cross-sectional survey. Pediatric dermatology Fulchand, S., Harris, N., Li, S., Barriga, M., Gorell, E., De Souza, M., Murrell, D., Marinkovich, P., Krishna Yenamandra, V., Tang, J. Y. 2021

    Abstract

    INTRODUCTION: Dystrophic epidermolysis bullosa is a debilitating skin condition, without curative treatment. Previous research has focused on the recessive variant, which is known to cause severe disease. Limited work focusing on the clinical manifestations and outcomes of dominant dystrophic epidermolysis bullosa is found (DDEB).METHODS: Analysis of an online survey of 42 DDEB patients.RESULTS: Self-reported severity of disease did not correlate with size of the wound or number of dressing changes, but did correlate with severity of pain reported in the last 12months (3.4 mild vs 6.8 severe disease, P=0.0002). Patients with severe DDEB also reported more severe internal disease symptoms, such as difficulty swallowing (62.5%, P=0.01) and greater analgesic use during dressing changes (4.4% mild vs 81.3% severe, P=<0.001).DISCUSSION: Patient perception of disease severity in DDEB appears to be most impacted by pain, presence of chronic open wounds, difficulty swallowing, difficulty walking, and anal strictures. As research on DDEB increases, future studies focused on these symptoms might be the most impactful for DDEB patients. However, distinguishing DDEB from other subtypes remains a challenge.

    View details for DOI 10.1111/pde.14802

    View details for PubMedID 34515355