Recent focus on the neonatal intestinal microbiome has advanced our knowledge of the complex interplay between the intestinal barrier, the developing immune system, and commensal and pathogenic organisms. Despite the parallel role of the infant skin in serving as both a barrier and an interface for priming the immune system, large gaps exist in our understanding of the infantile cutaneous microbiome. The skin microbiome changes and matures throughout infancy, becoming more diverse and developing the site specificity known to exist in adults. Delivery method initially determines the composition of the cutaneous microbiome, though this impact appears transient. Cutaneous microbes play a critical role in immune system development, particularly during the neonatal period, and microbes and immune cells have closely intertwined, reciprocal effects. The unique structure of newborn skin influences cutaneous microbial colonization and the development of dermatologic pathology. The development of the infantile skin barrier and cutaneous microbiome contributes to future skin pathology. Atopic dermatitis flares and seborrheic dermatitis have been linked to dysbiosis, while erythema toxicum neonatorum is an immune response to the establishment of normal bacterial skin flora. Physicians who care for infants should be aware of the impact of the infantile skin microbiome and its role in the development of pathology. A better understanding of the origin and evolution of the skin microbiome will lead to more effective prevention and treatment of pediatric skin disease.

Background/Objective: The h-index is a measure of research achievement. Individuals with similar h-indices should be equivalent in terms of scientific impact. However, this value is inherently biased toward fields with higher visibility and readership. To utilize the power of h-indices in predicting future research success and as a benchmark for academic advancement, niche fields like pediatric dermatology must be examined independently. Methods: Publicly available data were examined. A list of current pediatric dermatologists were obtained from the Society for Pediatric Dermatology's member directory. The following demographic information was obtained: fellowship certification year, PhD status, prior pediatric residency training, state/region, practice setting, academic appointment, number of publications, and h-index. Descriptive and analytic statistics were calculated. Results: A total of 317 pediatric dermatologists were included. Practice setting distribution was as follows: 54.3% academic, 32.5% non-academic, and 13.3% combined. H-index differed significantly based on pediatric dermatology certification year (P < .001), increasing as time from certification increased. Those in academics had higher h-indices than those in both non-academic and combined practice settings (P < .001 and .007, respectively). Professors (25.0) had higher h-indices than associate professors (11.0), who had higher h-indices than assistant professors (4.4) (P < .001). Conclusions: H-index increased with increasing academic rank and was highest among those working in academics. For pediatric dermatologists considering application for promotion, the h-index for each level can serve as a useful benchmark to guide decision-making.

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