The 4th Industrial Revolution, first mentioned in the Davos Forum in Switzerland in 2016, involves tremendous changes that speed up the transformation of human civilization. With the convergence of technologies in various fields, including artificial intelligence, the Internet of Things, autonomous vehicles, 5G, robotics, and gene editing, the 4th industrial revolution will affect human life in a wider range and faster pace than the previous industrial revolution.
In the health care sector, changes in the 4th Industrial Revolution are being applied without exception. This will be a big challenge for the future of dermatologists. Traditional methods of study or practice alone may not be enough to meet the needs of the new era. Diagnosis, such as radiology and pathology, will be replaced by artificial intelligence, and specialists will only be changed to roles that identify and take legal responsibility for diagnosis. Bio-sensors using IoT, big data, and artificial intelligence will be actively used for health monitoring and treatment. Customized prescriptions through genetic analysis and new treatments using gene editing will also bring about paradigm shifts in treating congenital diseases and cancer. We need to think about what to do to become a dermatologist ahead of the age of convergence, hyperconnectivity, and hyperintelligence. In addition, we should not lose the attitude of living life with the expertise and mission of dermatologists.

In recent years, there has been increasing interest in the role of vitamin D in skin diseases, and extensive laboratory and clinical studies have been conducted on the relationship between vitamin D and atopic dermatitis. A variety of immune cells, including macrophages, dendritic cells, and T and B lymphocytes, express receptors for vitamin D. In addition to its well-known role in calcium homeostasis, vitamin D plays a role in regulating both innate and adaptive immune systems, suggesting its potential immunomodulatory role in the process of allergic inflammation. Although the literature on the relationship between vitamin D and atopic dermatitis has shown various findings, numerous observational studies published so far showed the association between vitamin D deficiency and the risk of atopic dermatitis, and an inverse correlation between vitamin D levels and severity of atopic dermatitis. In addition, a number of randomized controlled trials have demonstrated that vitamin D supplementation in patients with atopic dermatitis resulted in significantly greater symptomatic improvement than placebo. Furthermore, the results from meta-analyses and systematic review of findings from previous clinical trials confirmed that vitamin D supplementation helps improve symptoms of atopic dermatitis. These evidences support that vitamin D is closely related to the severity of atopic dermatitis.

There are studies that assessed the association between vitamin D treatment and AD. The results are conflicting. These conflicting results may be associated with geographic location, age, season, ethnicity, and environmental factors. In addition, there were several limitations among previous studies on the relationship between vitamin D and AD, such as a lack of standardization for serum vitamin D measurements, small sample size and selection bias. In addition, the diagnosis and severity of AD was evaluated by different physicians, which may contribute to the differing results. Therefore, vitamin D has not been included in the routine treatment of AD because of the conflicting results of various studies.