August 2023

A lifelong attention to detail

It’s always difficult to pinpoint the exact moment at which you decide something, and I suppose that deciding that I wanted to pursue a career in dermatology was a similar experience. I think back, my love of baking as a young child set the scene. When I wasn’t studying or seeing friends, I was in the kitchen for hours on end and even set up a catering company as a teenager. I’ve always felt there was an overlap between baking and dermatology – the manual skill set, the attention to detail, and the importance of what the end product looks like is common to both.

Dermatology for me is the best speciality because you get this beautiful combination of medicine, and of practical surgery, all of which is undercut by a stream of fundamental science.

Falling in love with skin cells

Whilst I was studying medicine, I did a Bachelor of Arts in genetics, looking at the impact of epigenetic changes on the ability of skin cells to withstand types of stress. I fell even more in love with skin cells by understanding more how they worked, learning about the types of skin cell, and gaining an appreciation of their functions.  The capacity of our skin to act as a waterproof barrier, to protect us from external forces such as bacteria and UV radiation, and the ability of the skin to adapt to withstand these forces, fascinates me.

My lab work and studies also furthered the academic spirit within me. Dermatology is cool in that sense – it’s based on fundamental skin pathophysiology, its immunology and inflammation plus its capacity to repair. Treatments given in dermatology such as steroids and newer biologic agents tend to work by modifying fundamental molecules in these pathways. Also, skin biopsy, tissue diagnosis and immunofluorescence imaging forms a huge part of dermatology. All these things excite the nerd within me, as it’s a speciality where I can really combine patient treatment with fundamental pathophysiology.

Dermatology for me is the best speciality because you get this beautiful combination of medicine, and of practical surgery, all of which is undercut by a stream of fundamental science.

The growing field of psychodermatology

I’ve always been interested in mental health and worked in psychiatry for four months. As a doctor we must be careful not to just see the medical aspect of our patients, but also to consider the wider biopsychosocial model – so how the condition might impact your patients day-to-day in terms of what they can do or how they feel. 

As the skin is in such a privileged and exposed position on the body, the impact the way the skin looks, or feels, can be huge. Dermatology is beautiful, as the changes that you make do not only treat the skin condition but can really help to propel a person forward in their life. It’s all about giving patients more confidence and allowing them to do the things they might otherwise feel hindered from. The up-and-coming field of psychodermatology is something I’ve got my eye fixed on and I’m excited to see how it expands.

Looking to the skin for clues

As a Junior Doctor we rotate every four months during foundation training. During each rotation I was able to see the impact of systemic disease on the skin, and I became more and more interested in the role of dermatology. I find dermatology so fascinating and unique in that we clearly treat primary skin disorders such as eczema, or psoriasis, but we are also crucial detectives in picking up clues in the skin that suggest a different primary disorder. From there on it is our role to investigate, signpost and refer the patient to the correct specialist.

It is cheesy to say that I was born to do it, but let’s just say that my likes, interest, and past self all feel that they have led to this.

Dr Charlotte Muehlschlegel

Charlotte is an aspiring Dermatologist and is currently a junior doctor working at University College London Hospital in London. She completed her undergraduate medical studies at University of Cambridge, Trinity College where she intercalated with a BA in Genetics. She is undertaking a Master’s in Human Tissue Repair in the coming year. 

Dr Charlotte Muehlschlegel
University College London

Find Charlotte on LinkedIn here.

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