Advances in the fields of genetics and pharmacology and the understanding of disease mechanisms have occurred apace in recent years in dermatology. As the pathophysiology of skin diseases become clearer, treatments have become more focused and effective, but new treatments bring new side-effect profiles and further considerations for the prescribing physician. The diagnostics of skin disease have also progressed and the role of automated systems in the recognition of skin lesions is being explored. Integration of new knowledge and old is a challenge to the modern physician treating patients with dermatological disease.