What’s the body’s largest organ—and the site of the most common form of cancer in America?
If you answered skin to the question above, you’re right. Helping patients keep their skin healthy and identifying the causes of skin diseases and rare skin disorders are the twin goals of Kevin Gaddis, MD, FAAD. Gaddis, a dermatologist and dermatopathologist, rejoined University of Minnesota Health this year after completing a dermatopathology fellowship at the University of Pennsylvania.
We asked Gaddis about his passion for patient care, and how he sees dermatology evolving in the future.
My natural interests in science and medicine were always strongly supported by my family. My father (a pharmacist) and grandfather (a physician) were important role models in pursuing science and medicine.I was introduced to the field of dermatology by my medical school mentor. I enjoyed the visual nature of the field, the focus on clinical evaluation and reasoning, the satisfaction of being able to see when treatments work and the patient gets better, and the broad scope of practice—which includes surgery and pathology.
Dermatopathology is a subspecialty of dermatology and pathology focused on the diagnosis of skin conditions. If a patient has a rash or an unusual spot on their skin, a doctor may choose to take a biopsy for more information. That biopsy specimen is processed into glass slides, and then a dermatopathologist reads or interprets the slides. Together with the clinical information, we can often help the clinician and the patient arrive at the right diagnosis. This is important because the right diagnosis is the foundation for getting our patients the best treatment.
One of our most important tasks is diagnosing pigmented lesions, which can range from harmless freckles and moles all the way to melanoma. Because melanoma is a potentially deadly cancer, that decision carries high stakes. I feel very fortunate to have studied under international experts at the University of Pennsylvania, and I’m excited to use that training to help our patients.
In both a physical and a sociocultural sense, our skin is the interface between ourselves and the rest of the world. When a patient is suffering from a skin condition, they are often dealing not only with the symptoms but also the response of others to their condition. It's important for doctors to consider the human aspects of the conditions we treat. Treating and clearing up a condition—wherever and whenever possible—motivates me. When a condition can't be completely cured, I find purpose in providing the best-possible care for the person and tailoring treatments based on what matters most to the patient.
What’s something we all should do to keep our skin healthy?
1. Sunscreen. It's not a particularly flashy answer, but it is probably the single most important intervention a person could incorporate into their daily routine. An SPF 30 or greater, broad-spectrum (covering UVA and UVB) sunscreen can help prevent skin cancers, photoaging (fine lines and wrinkles), and pigmentary changes (like dark spots on the face and light spots on the forearms), among other things.
2. Moisturizer. Also not earth-shattering news, but evidence suggests it may prevent eczema from developing in babies and may prevent flare-ups of eczema in children and adults alike.
In addition to caring for patients, I also teach medical students and residents who work alongside me in clinic. I have always enjoyed the role of teaching physician; it's an honor to help train the next generation of physicians. They also help keep me on the cutting edge of medical practice.
Genetics will probably have the single biggest impact on dermatology and many other medical fields within our lifetime. Genetic technologies are primarily limited today by cost, but I anticipate they will continue to become more precise and accessible over time. Gene expression profiling will help us distinguish between harmless moles and melanoma, and I also expect genetic testing will help us identify patients at risk for skin cancer or certain medication reactions. In the future, we may also be using CRISPR technology to help prevent some of our most debilitating and lethal diseases.