Early in my career, I was invited to join a weekly teleconference with a group of dermatologists and dermatopathologists in Vietnam. At the time, I was still settling into practice—still finding my footing—but I said yes. I didn’t know then how meaningful that commitment would become, or how one case, in particular, would leave such a lasting impression.
The case was that of a young girl who had been suffering from persistent, red, itchy, scaly skin for most of her life. Her physicians had been managing her as best they could, trying treatments for eczema and psoriasis, but nothing seemed to help. There was something different about her skin—something that didn’t quite fit the usual patterns.
As the team shared close-up images, I noticed something striking. Around the edges of her lesions were thin, fragile scales that looked like they were peeling outward in two directions. I remembered the term from my board exam prep: ichthyosis linearis circumflexa—characteristic double-edged scales seen in a rare condition called Netherton syndrome.
Her biopsy, interestingly, was largely unremarkable—non-specific findings that didn’t point clearly to any one diagnosis. And that’s the challenge with Netherton syndrome. It often hides in plain sight—masquerading as eczema. Without a high index of suspicion, it’s easy to miss.
I had never seen Netherton in person. But because I had recently taken my boards, the image and description were still fresh in my mind. I hesitated for just a moment—then spoke up and suggested the possibility.
The Vietnamese team followed up with genetic testing, which confirmed the diagnosis. The child was referred to appropriate specialists, including immunology and genetics, and finally began receiving care tailored to her specific needs.
I don’t know that little girl. I’ve never seen her face beyond a clinical image. I don’t know her voice, her laugh, or what kind of games she likes to play. And she’ll likely never know I exist.
But that doesn’t matter.
Knowing I played even a small part in her journey—offering a piece of knowledge that helped lead to a correct diagnosis and more appropriate care—is incredibly gratifying. It’s one of the quiet privileges of this profession: to help someone from afar, to contribute anonymously to their healing.
That experience is the reason I’ve continued to show up to these weekly teleconferences. It reminded me early on that medicine isn’t about borders or titles—it’s about connection, humility, and the willingness to learn together.
Each week, I log in not knowing what case might come up, or whether I’ll be able to contribute. But I keep showing up, because once in a while, a conversation can change someone’s life.
And that, to me, is worth everything.
About the Author
Dr. Anh Pham, MD, FAAD, is a board-certified dermatologist and the founder of CutisCo Dermatology. He is committed to delivering high-quality, patient-centered care and is passionate about making dermatology more accessible, inclusive, and compassionate for all. Through his work at CutisCo and his dedication to mentorship, Dr. Pham aims to create lasting, positive change—empowering future clinicians and expanding access to care in a way that leaves a meaningful impact on both individual lives and the world at large.
