With this issue, I conclude my tenure at the helm of the Journal as Editor-in-Chief. I believe most editors have mixed emotions at this time of transition, elated at having run the course and completed the assigned mission combined with a tinge of sadness that comes with all “graduations” seeing the Journal move on into another era. Rather than giving in to sentimentality, it may be a more appropriate time to sum up the Journal at least in this Editor's view and attempt to predict where it may go in the years to come.

Where did we come from? Twelve years ago, the Journal, like most others, was completely composed of papers (literally paper) submitted by authors to the editorial office, followed by the trail of peer-review, revisions, acceptance and transition to publisher, formatting, proofing, and then finally assignment to an issue which was then printed and mailed to subscribers. All of this process required a herculean record-keeping procedure and expenses related to transfer of this material were significant. At that time, we were concerned about fulfilling the mission of the Journal as it appeared the bulk of contributions were made by those in developed countries who could afford all of the expenses incurred by this process. New submissions came at a rate of approximately two manuscripts per day, and tracking all of the manuscripts in review and revision was consuming the majority of our editorial office efforts.

What were the major developments in the interim? While we were on the cusp of the digital era in medical publication at that time, I do not believe we could have entirely predicted how this era would completely alter our lives in the relatively short time of one decade. The most profound effect on the Journal is that the process of submission, peer-review, and publication is now truly a global one. From two submissions daily, we now receive six submissions daily. As opposed to receiving manuscripts from only developed countries with high GNP's, we currently receive submissions from over 75 countries and also call on experts from these countries to evaluate submissions, staying true to the concept of peer-review. Expenses related to mail and manual tracking have been replaced by those of time required to intake and monitor the progress of this larger and more diverse body of manuscripts as they move from submission to publication. Publication takes place in two spheres, the digital on-line world, supported by libraries, societies, HINARI, and other groups as well as the traditional print formats. The Journal is robust in every way, and interest in publication as well as the review process is strong.

Where is the Journal headed? In order for the Journal to compete for relevance in the new world, it must continually adapt to changes and challenges inherent in our digital age. Once taken for granted was the support of Societies and advertisers for the print version of the Journal. Competing for this support will require adaptation to the most relevant means of reading and acquiring new knowledge. This knowledge must now be pushed out at a more rapid pace for consumption at the bedside or whenever needed and in a format compatible with the varied devices utilized on a daily basis for accessing medical literature. Parallel to this process of rapid adaptation to newer and more robust formats is the need for continued interest in the process of medical publication. Volunteerism is paramount to this cause. A critical component of all medical publication is the continued interest by the vast majority of authors, reviewers, editors, and others who contribute their time and most importantly their intellect to this process for little or no personal gain. All editors learn during their tenure that this spirit of intellectual curiosity and desire to contribute is absolutely necessary to ensure success of any journal. To pique this interest and to keep it at a consistently high level is perhaps the most difficult task of any editorial staff. Based on current experience, I am confident this spirit is alive and well and will carry the Journal on to its next iteration in whatever format required to maintain relevance and leadership.

I conclude by thanking the many authors, reviewers, editorial board members, and editorial staff with whom I have had the privilege to work over the past several years. Your knowledge, energy, and creativity have enhanced all of us during this time. The support of the International Society of Dermatology leadership has been uplifting and unwavering. My best wishes to all of our readers and contributors and hail to the new Editor-in-Chief!