Abstract
BACKGROUND: Skin diseases contribute to a massive and often overlooked component of the global disease burden, highlighting the need for a better understanding of the dermatologic research landscape and its key drivers of excellence. AIM: To explore the national, institutional, and individual-level determinants that shape dermatologic research excellence worldwide. METHODS: We analyzed the publicly available Stanford-Elsevier Lists of the top 2% most-cited scientists (2017-2023), extracting scholars classified in Dermatology & Venereal Diseases to identify excellent dermatologic scholars (EDS). EDS records were then linked, based on affiliation data, to country-level indicators (Universal Health Coverage [UHC], Human Development Index [HDI], Gender Inequality Index [GII], national budgets, and disease burden), institutional rankings (Quacquarelli Symonds [QS], Times Higher Education [THE], and Academic Ranking of World Universities [ARWU]), and individual attributes (gender and academic age). Outcomes were EDS counts by country/institution and scholar-level bibliometrics (citations excluding self-citations, modified H-index, and composite score). RESULTS: EDS were overwhelmingly based in high-income countries (97.9% career-long; 94.5% single-year) with the EURO region contributing ~48% of EDS and exhibiting highest densities (0.585 and 0.482 per 100,000), while low-income settings had ~0.002. The top 20 institutions hosted ~21% of all EDS. Women comprised 22.9% (career-long) and 28.6% (single-year) of EDS; men had higher median citations and modified H-indices. Academic age correlated positively with modified H-index (ρ = 0.312 career-long) and C-score (ρ = 0.145 single-year), and each additional year predicted higher citations (β = 84.1 career-long; β = 2.6 single-year). In adjusted models, higher HDI and UHC aligned with higher citation counts. CONCLUSION: Dermatologic research excellence remains concentrated in high-income, predominantly European and Anglophone ecosystems, within a small cadre of elite institutions and among older, male scholars. Policymakers should focus on targeted funding for under-represented regions and institutional reforms to ensure equitable career advancement for women in academic dermatology.