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November 2005


Arch Dermatol. 2005;141(11):1469-1470. doi:10.1001/archderm.141.11.1469

The ARCHIVES must be commended for delving into the subject of genomics in the February 2005 issue. This new frontier of medicine is teaching us how to adjust our treatment to individuals rather than adhere to the protocol for the “average 70-kg man.” The tools for making these decisions are nearly within our reach, and we are advancing rapidly. Truly, we are headed for a new paradigm in patient care.

While this may seem to have little clinical value for most practicing dermatologists at this time, I wish to point out that our patients have the ability today to affect the expression of their genome. Diet, or more precisely, the chemicals in the diet have been shown to act as ligands for transcription factor receptors, to serve as signaling molecules, and to be metabolized by primary or secondary metabolic pathways thereby altering concentrations of substrates or intermediates.1

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