The skin is the largest organ of the human body that serves a vital role in many dynamic processes that maintain homeostasis. Composed of multiple cell types, our skin forms an effective barrier against environmental insults from sun exposure to direct contact with chemical agents, microbes, and physical trauma. The skin also confers the first-line of innate immune defense––a process that can go awry in disorders such as cutaneous T-cell lymphoma (CTCL) and immune-related adverse events. Melanocytes located in the basal cell layer of the epidermis produces the pigment melanin that absorbs ultraviolet (UV) light and reduces the risk of developing skin cancer. In many societies, the appearance and perception of one’s skin and hair also touches deeply upon issues of health, wellness, and identity. In this issue, we present 22 articles that deeply examine the mechanisms, pathologies, and therapeutics of the skin and dermatology.
Firstly, we had multiple authors share insight as to how the skin heals and maintains during times of stress. These articles, while centered on a similar topic, all offer unique expertise on wound healing and how our skin has many vital responses and functions that enable its role as a protective and active organ even in the presence of a multitude of stressors. Kinins and transcription factors are described in great detail, helping to emphasize the complex and monumental task that our bodies face each day in maintaining, and at times re-establishing, skin homeostasis.
Authors also took a particular focus on the immune system and its roles in both skin function and dysfunction, commenting on B and T cell lymphomas, advancements in the treatment of psoriasis, including the structural makeup of biologics that are being used to treat it, the promise of JAK inhibitors in treatment of disorders of macrophage activation, and toxicities of immune checkpoint inhibitors. Modern research in a number of medical disciplines, and beyond, has placed an increased emphasis on the field of immunology and immunotherapy. We knew it would be of critical importance for this issue to promote and highlight the work of researchers who were focusing in these topic areas as they represent a significant portion of the future of research and treatment in dermatology and its related disciplines.
Of particular note, the articles previously mentioned range in their scale from reviews of current research to commentary on the role of the dermatologist in utilizing and understanding modern advances in disease morphology, presentation, and treatment. The authors successfully comment on and present knowledge of extremely valuable topics. With research in the field expanding so rapidly and new treatments being theorized and tested more regularly, their breadth and meticulous attention to detail serve to contribute greatly to the growing body of literature.
Importantly, a number of case reports and case series are presented. Rosen and Lowery present a case of African tick bite fever in a patient from the United States, commenting on an infectious disease that is commonly seen in travelers returning from sub-Saharan Africa that has its own set of challenges related to treatment and diagnosis. Siegel and Ko present a case of diltiazem-associated photodistributed hyperpigmentation, a topic which has limited exposure in scientific literature to date. All of the cases presented focus not only on important conditions, but also importantly comment on the challenges, and promise, of their novel treatment course.
The impact of skin cancer globally cannot be understated, and authors approach it from different perspectives in our issue. The mechanisms of melanoma surveillance are presented alongside cutaneous photoprotection. The importance of both the innate medical and public health implications of skin cancer are explored, serving as a powerful reminder of the momentous steps being taken to treat such a deadly and highly prevalent set of conditions.
The original research, case reports, reviews, perspective piece, and interview contained in this issue showcase the richness of the biology and medicine of the human skin. Our aim was to share groundbreaking research in a multitude of disciplines related to the skin and its systems. Authors comment on features integral to the function of the skin, such as the basic structure of keratin heterodimers, all the way up to the modern role of the dermatologist. We hope the articles herein encourage researchers and physicians alike to take a deep, critical dive into the latest advances and reviews presented, and serve as reservoirs of knowledge for those who seek them.
Our Editor’s Picks highlight five articles that describe strategies for cutaneous photoprotection, a novel investigation of keratin 1/10 helix 2B heterodimer, a case report of African tick bite fever, the intricacies of transcriptional networks in the re-epithelialization process, and a case series on intravascular large B-cell lymphoma. These manuscripts delve into the topic of skin from the public health, medical, and molecular perspectives, providing a rich overview of the depth and breadth of this YJBM issue on Skin.
This issue would not have been possible without the efforts of our dedicated team of Manuscript Editors, Editor-in-Chiefs Devon Wasche and Amelia Hallworth, and Editorial Coordinator Kate Woodford. We would like to especially thank Dr. Richard Edelson for his instrumental guidance on our special partnership with the Yale Department of Dermatology, and Fatima Mirza for her help at every stage.