Pioneers in Dermatology and Venereology: An interview with Professor Brigitte Dréno

Year of birth: 1953. Dermatology attracted me because it uniquely combines visual diagnosis, clinical medicine, and fundamental biology. The skin is an accessible organ that reflects systemic disease, immune function, and environmental interactions, allowing scientific discoveries to be directly translated into patient care. This interface between clinical observation and biological mechanisms ultimately convinced me to pursue dermatology. I was fortunate to be trained by several outstanding dermatologists and scientists within French academic dermatology, particularly in environments strongly connected to the Institut national de la santé et de la recherche médicale (INSERM). These mentors instilled in me not only clinical excellence but also a rigorous scientific mindset and a deep interest in translational research. Later, international collaborations broadened my perspective, helping me see dermatology as a global and multidisciplinary field. Beyond formal mentors, I learned the most from working at the interface between clinicians and basic scientists. Among dermatologists, Prof. Henri Barrière and Prof. Pierre Litoux were fundamental to my training, while Prof. Jean Paul Soulillou, a scientific immunologist, shaped me as a scientist. “Never separate clinical observation from scientific questioning.” This advice guided my entire career and helped me build bridges between bedside medicine and translational research. I established the first GMP cell and gene therapy unit in a hospital in France, which enabled me to develop Tumour-infiltrating lymphocytes (TILs) for melanoma and, more recently, a regenerative dressing for deep second-degree burns. I was honoured with the Legion of Honour (Légion d'honneur) by the French President. Like many clinician-scientists, I have faced situations where promising scientific advances could not be translated into clinical practice as quickly as I hoped, often due to regulatory, financial, or structural barriers rather than scientific limitations. One example was losing half a million euros in funding that I had obtained from a foundation for groundbreaking research on the role of extracellular vesicles produced by Cutibacterium acnes (C. acnes) in acne. This sum would have supported a researcher for 3 years, but the refusal by a French university and, above all, by the INSERM, was based solely on administrative reasons, with no possibility of discussion. I vividly recall an evening in Dallas with three French professors, Prof. Revuz, Prof. Dubertret, and Prof. Ortonne, at an epic rodeo, an experience that will always remain in my memory. At one point, I genuinely thought that France might lose three of its luminaries of dermatology. What I enjoy most in my profession is its diversity as it allows me to see patients, teach, conduct research, and collaborate across disciplines. Dermatology offers the opportunity to combine human contact, intellectual challenge, and visual medicine daily. Definitely the Opera. My husband and I have visited all the major opera houses around the world and have been season ticket holders in France for years. As a musician, I admire Frédéric Chopin, as a painter, Claude Monnet, and as a writer, Blaise Pascal. Each left an enduring mark on their respective disciplines. My most recent discoveries focus on two areas: The role of the skin microbiome in acne and the importance of C. acnes as a commensal bacterium in protecting the skin barrier, highlighting that we should not aim to eradicate it, as it has been common practice for the past 40 years. How the secretome of fetal cells is a remarkable source of regeneration without risk of rejection, opening the possibilities for faster healing without scarring abnormalities and enabling better aging. A day when I can read articles, work with my team, avoid administrative tasks, do some sport, and finish by having dinner with my family. The greatest challenges facing dermatology in the next 10 years will be the risk of being absorbed by other specialties such as infectious diseases, vascular medicine, internal medicine, and oncology; the failure to embrace and properly use artificial intelligence rather than fear and resist it; and the inability to assert and defend its position as the leading medical authority on skin health in social media and in society more broadly. The situation is urgent for dermatology, but I believe it can succeed with a strategy adapted to societal changes and by anticipating future developments. The major breakthroughs in dermatology will arise from the convergence of biology, technology, and personalized medicine. Microbiome-based diagnostics and therapies will move from descriptive studies to targeted clinical interventions. Precision immunomodulation, driven by molecular and cellular profiling, will allow more individualized treatment of inflammatory and autoimmune skin diseases. Artificial intelligence will increasingly support diagnosis, prognostication, and therapeutic decision-making. Finally, regenerative and reparative dermatology—combining secretomes, extracellular vesicles, and bioengineered skin substitutes—will open new perspectives in wound healing, scarring, and skin aging. Remain curious, rigorous, and humble. Never separate the patient from the science, nor clinical observation from biological questioning. Dermatology advances through interdisciplinary thinking, collaboration, and continuous learning, guided by respect for patients and intellectual integrity. Show how dermatology is an essential discipline in a world where skin plays a key role in the context of pollution and climate change. Strengthen the image of dermatology every day among patients, politicians, and colleagues in other disciplines. None declared. *Note: The Pioneers in Dermatology and Venereology interview was conceived and conducted by Johannes Ring.