Phenotypic Dermatology: Conceptual and Cytometric Foundations

Abstract

Phenotypic Dermatology represents a new scientific paradigm that shifts dermatological diagnostics and therapy from morphological observation to cellular-phenotypic measurement.
Traditional dermatology, relying on visual description of primary and secondary lesions, cannot explain the true cellular mechanisms underlying visible skin changes.
The proposed approach interprets the skin as a dynamic system of interacting cell subpopulations, whose phenotypes determine the inflammatory, regulatory, and regenerative states of the tissue.

Using methods of flow cytometry and the author’s patented technology — the cytoimmunogram of the skin (CIGS) — it becomes possible to quantify the subpopulation composition of skin cells and to evaluate their phenotypic balance objectively.
This allows clinicians to replace descriptive diagnosis with measurable cellular criteria and to move toward precision and personalized dermatology.

Theoretical Framework

Phenotypic Dermatology integrates cytology, immunology, systems biology, and conceptual analysis.
Its core assumption is that the phenotype of a cell subpopulation, rather than the morphology of a lesion, is the true diagnostic unit of the skin.
By identifying stable and dynamic phenotypic patterns, the theory explains the transition of the skin between inflammation, repair, and homeostasis.
The conceptual approach extends beyond morphology, introducing a phenotype-based language of diagnosis and a reproducible framework for evaluating disease dynamics.

Experimental Basis

The theoretical foundations are supported by a series of patented inventions and laboratory studies:

1. Method for obtaining a viable heterogeneous population of skin cells (RU 2502999 C1).
2. Method for determining the subpopulation composition of skin cells and obtaining the cytoimmunogram (RU 2630607 C1).
3. Wound-healing composition Cellgel® (RU 2481115 C1).
4. Device for activation of reparative potentials of skin cells (RU 159463 U1).

These technologies enabled reproducible phenotypic profiling of skin cell subpopulations and confirmed the link between specific phenotypes and clinical states such as atopic dermatitis, psoriasis, and chronic wounds.

Practical Implications

The cytometric analysis of skin phenotypes provides:

• Objective diagnostics — quantitative assessment of inflammatory and regenerative activity.
• Personalized therapy — selection of treatment based on the patient’s individual phenotypic profile.
• Therapy monitoring — tracking phenotypic shifts during healing and evaluating treatment efficiency.
• Drug development — design of agents that modulate specific cellular phenotypes, exemplified by Cellgel®.

Thus, Phenotypic Dermatology transforms a visual, symptom-based discipline into a measurable and predictive biomedical science.

Perspectives

Future research directions include:

1. Creation of an international digital atlas of skin cell phenotypes.
2. Integration with single-cell and spatial transcriptomics for multi-omic mapping of skin pathology.
3. Application of artificial-intelligence algorithms to interpret cytoimmunograms and predict therapeutic outcomes.
4. Development of phenotype-targeted regenerative therapies and standardized diagnostic panels.
5. Establishment of Phenotypic Medicine as a broader field, with skin as its primary experimental model.

Conclusion

Phenotypic Dermatology resolves the long-standing gap between visible symptoms and hidden cellular mechanisms.
It turns dermatology from the art of observation into the science of measurable causes, marking the beginning of a new era — where the state of the skin is defined not by what is seen, but by what can be quantified.

Author: Sergey V. Goltsov, MD, PhD