Personalizing dermatology: the future of genomic expression profiling to individualize dermatologic therapy.

At the start of the 21st century, the human genome project provided the scientific community with an enormous array of information as genetic blueprints. A landmark period, yet its potential contribution to medicine at the time was limited and unknown. However, with new technological advances, the benefits of identifying genomic profiles became apparent. This article reviews the historical accomplishments made by the human genome project, future applications of genomic expression profiles with the use of microarray gene chip technology, and the pharmacogenomic translational application of these models to dermatology. A new scientific movement in dermatology has begun with intentions of discovering individual genomic profiles responsible for dermatologic disease and drug metabolism, so that medical management can be personalized towards the genome rather than the disease. This review shows how pharmacogenomics has taken the lead in forming a basic framework of revealing specific drug metabolic pathways in the skin that can consequently be altered to maximize and minimize therapeutic efficacy and side effects, respectively. Dermatology as a model field in medicine has started to take advantage of these discoveries upon which deciphering genetic profiles can be used to enhance medical treatment.

The linear excisional wound: an improved model for human ex vivo wound epithelialization studies.

BACKGROUND/PURPOSE: Wound healing is a complex process that involves multiple intercellular and intracellular processes and extracellular interactions. Explanted human skin has been used as a model for the re-epithelialization phase of human wound healing. The currently used standard technique uses a circular punch biopsy tool to make the initial wound. Despite its wide use, the geometry of round wounds makes it difficult to measure them reliably. METHODS: Our group has designed a linear wounding tool, and compared the variability in ex vivo human linear and circular wounds. RESULTS: An F test for differences in variances demonstrated that the linear wounds provided a population of wound size measurements that was 50% less variable than that obtained from a group of matched circular wounds. This reduction in variability would provide substantial advantages for the linear wound technique over the circular wound punch technique, by reducing the sample sizes required for comparative studies of factors that alter healing. CONCLUSION: This linear wounding tool thus provides a method for wounding that is standardized, provides minimal error in wound gap measurements, and is easily reproducible. We demonstrate its utility in an ex vivo model for the controlled investigation of human skin wounds.