Skin Deep - Clinical & Cosmetic Dermatology Blog

Skin Deep is a blog for dermatologists and skin care professionals with focus on theoretical, cosmetic and aesthetic dermatology. This blog is associated with ‘Dermatologists Sans Borders’ one of the largest curated groups of skin care professionals on facebook. If you are looking for non-technical information, please visit

The Loyalty of Anatomy

nerves of left upper extremity
nerves of left upper extremity (Photo credit: Wikipedia)
The medical knowledge is never static. Most of the drugs we prescribe today were not even there few years back. Personalized medicine is just around the corner, though he is taking a lot of time to come out of the corner. Many theories have been shattered and new ones made. As I posted last week, the mitotic activity of the good old basal cells is highly suspicious!

Though I never trusted the loyalty of physiology or pharmacology, I used to respect anatomy. Ulnar nerve has remained ulnar nerve over the years. It still remains medial to the triceps tendon and will remain so for ever. So for me anatomy was loyal and reliable. Unfortunately not any more.

In the initial days of my PG, in the first few pages of Moschella, I read about the superficial and deep vascular plexus of the skin. Like most things in anatomy, I believed it without actually seeing it. I trusted Moschella to have seen it all. But this article(1) make me doubt the loyalty of anatomy in general and also suspect everything in dermatology that I have not seen with my own eyes!

1. Geyer, SH. "The dermal arteries of the human thumb pad." 2013. 

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5 things Dermatologists should not do

DNA (Photo credit: Steven2005)
What happens when the DNA replicates without cellular replication. It leads to formation of ‘polyploid’ cells. Though polyploidy has been noted in megakaryocytes, bone marrow, myocardiocytes and hepatocytes, it has not been described much in skin. A new study proposes that basal keratinocytes may show up to 50% polyploidization, though its functional relevance is not yet known. 

AAD followed the footsteps of 42 other specialties and published a list of ‘5 things Dermatologists should not do’ along with the commentary from Dr. Goldenberg.


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Evaluating Industry Attractiveness of Cosmetic Dermatology: an India & Middle East perspective. (Part 1)

Westlake Dermatology Prep Oval 003
Westlake Dermatology Prep Oval 003 (Photo credit: Associated Fabrication)
DICODerm is gathering steam. Thanks for all the contributions from +Apratim Goel, +Feroze Kaliyadan+Geraldine Jain and +Sunaina Hameed. Special thanks to +Feroze Kaliyadan for the contributions on positioning standards. Will work on it some more and get some technical expert to have a look. I was actually planning to write several posts on #DICODerm, but most of the issues I wanted to highlight have already been discussed. So I am starting yet another interesting (probably a little controversial) topic:

If you attend a dermatology conference in India or Middle East, there is a very high probability that you will be surrounded by dermatologist-CEOs (If you are not one yourself). I don’t think you will find that many CEOs in any other specialty. The dermatologist-CEOs have added a unique dimension to the cosmetic dermatology industry and have ended the era of brand monopoly. Can all these dermatologist-CEOs make it big? Unlikely, as in any other business. Can the corporate brands strike back? Depends, on their strategic capabilities.

I am not an MBA, but for the last few months I am surrounded by business minds and I am extending few lessons I have learnt from them to write this series.

My motive is rather selfish. I am just trying to learn how to apply business principles in real world situations in health care. But it may help budding dermatologist entrepreneurs to position their business better. This may also help consumers to make informed decisions too. For a start: Should you, as a consumer consider having your BOTOX® in a brand or an individual clinic? We shall try to answer questions like this in due course.

I shall use the popular Porter five forces analysis:

Illustration of Porters 5 Forces. Illustrates ...
Illustration of Porters 5 Forces. Illustrates article Porter 5 forces analysis (currently available in 11 languages). (Photo credit: Wikipedia)

  • Threat of new entrants
  • Threat of substitute products or services
  • Bargaining power of customers
  • Bargaining power of suppliers
  • Intensity of competitive rivalry

Here are my satirical views on the cosmetic dermatology industry and my white paper on research methodologies in cosmetic dermatology.

What are your views on the cosmetic dermatology market based on the above five forces?

Read the full series on Cosmetic Dermatology Industry here

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About Me

As a Dermatologist and Informatician my research mainly involves application of bioinformatics techniques and tools in dermatological conditions. However my research interests are varied and I have publications in areas ranging from artificial intelligence, sequence analysis, systems biology, ontology development, microarray analysis, immunology, computational biology and clinical dermatology. I am also interested in eHealth, Health Informatics and Health Policy.


Bell Raj Eapen
Hamilton, ON