Editorial Concern about Future Direction of Dermatology

An editorial published in the May 2014 issue of Dermatology Times (“The future of dermatology: a discipline of disease or aesthetics?”  Volume 35 , page 10) by editorial board member Dr. Norman Levine (private dermatology practice in Tucson, Arizona), comments on the growing trend of some dermatologists to place more emphasis on aesthetic patients than those with skin diseases. He wrote, “The most accomplished medical students are accepted into dermatology residency programs that provide them with outstanding educational opportunities. Once the three-year process is complete, the new dermatologists are free to forget much of what they learned about the complex processes of the skin and proceed to make their fortunes by injecting Botox (onabotulinumtoxinA, Allergan) and fillers.” In some cases (especially in areas remote from dermatology residency programs), Dr. Levine reports that patients with “complicated cutaneous autoimmune diseases” cannot find dermatologists in their communities who are willing to treat them, and they must rely on other physicians such as rheumatologists for their skin disease management.