Major advances in skin biology and skin diseases are heralding new and more specific forms of treatment that are based on better characterization of pathological mechanisms involved in the individual diseases. The advances that we have seen are being made by dermatologists, skin biologists, and others who have come to appreciate the skin as an organ that is reflective of many important systemic mechanisms. In this commentary, I identify some of what I feel are the most important advances that will be the basis for many future studies.