In this episode of Under Your Skin, Dr Nick Brownstone chats with Dr Brian Kim to ask about the rarest disease he’s seen in his career and hear his thoughts on the future of dermatology.

What’s the rarest disease you’ve seen in your career?

Dr Kim describes the case of a pediatric patient with eczema who was referred for molluscum in the setting of eczema. Dr Kim suspected an immunodeficiency due to the extent of the patient’s molluscum and discovered the patient had a mutation in the CARD11 protein. The patient was within a cohort of the first patients with a CARD11 deficiency.

How will dermatology be practiced 10 years from now?

Dr Kim predicts 3 major shifts in the practice of dermatology over the next 10 years. First, he believes more specialization will develop, which will result in more delegation. Second, he anticipates that artificial intelligence will play a role in dermatology. Last, he foresees that randomized trials will lose some significance as targeted therapeutics continue to emerge.

Which conditions do we need better treatments for?

Dr Kim emphasizes that dermatology needs better treatment for chronic itch. He feels there is a significant misunderstanding about itch being unimportant even though it’s the most common symptom seen in dermatology.