4P Dermatology: A Shift to a Comprehensive Patient-Centered Model

Advances in dermatology are embracing a patient-centered, proactive approach through the ‘4P model’: Personalized, Predictive, Preventive, and Participatory care. This shift aims to improve treatment efficacy and safety as well as patient's quality of life. This review explores the applications of ‘4P medicine’ in dermatology, highlighting key concepts and examples like innovations in onco-dermatology and the skin microbiome. In onco-dermatology, molecular profiling guides targeted treatments, while genetic insights improve risk prediction and prevention. Genetic profiling, such as the identification of BRAF mutations in melanoma, has enabled targeted therapies like BRAF/MEK inhibitors to improve patient outcomes. Predictive technologies, including machine learning, are enabling early detection and risk assessment for both melanoma and non-melanoma skin cancers. Preventive strategies focus on proactive skin care, with public education campaigns and digital tools to increase sun protection behaviors and early detection. Participatory care engages patients in decision making, leading to better adherence and outcomes. This integrated approach optimizes outcomes and reduces the burden of skin cancer. Microbiome research has also transformed dermatology, enabling personalized treatments that target microbial imbalances in conditions such as atopic dermatitis, psoriasis and acne. Predictive dermatology uses microbiome signatures to forecast disease risk and response to treatment, enabling earlier intervention. Preventive strategies aim to maintain a healthy microbiome and prevent disease exacerbations. Participatory dermatology encourages patients to engage in microbiome-focused skin care to optimize outcomes. However, challenges remain in terms of treatment optimization, economic sustainability, ethical considerations and equitable access to care. Addressing these challenges requires innovative solutions, collaborative research, and strategies to ensure the accessibility and cost-effectiveness of dermatologic care.