A Conversation With Ivan V. Litvinov, MD, PhD, FRCPC

Dr Litvinov is an assistant professor and director of dermatology research at McGill University in Montreal, Quebec, Canada. He earned his PhD degree in cellular and molecular medicine at the Johns Hopkins School of Medicine in Baltimore, MD, and his medical degree at McGill, completing dermatology residency training at McGill University Health Centre (MUHC). Prior to joining the faculty at McGill, Dr Litvinov practiced as an assistant professor and dermatology clinician-scientist at the University of Ottawa between 2015-2017.

During 2019-2021, Dr Litvinov served as regional director (Quebec) of the Canadian Dermatology Association. Currently, he serves as the president of the Skin Research Group of Canada and as a board member of the International Society for Cutaneous Lymphomas. He is also actively involved in the literature, serving as an associate editor of Journal of Cutaneous Medicine and Surgery (JCMS) and Frontiers in Medicine and as a deputy editor of JCMS Case Reports.

He is active in cutaneous research, particularly studying cutaneous lymphomas, keratinocyte carcinomas, and melanoma, and his research is supported by various grants from the Canadian Institutes of Health Research (CIHR). As part of his duties as director of dermatology research, Dr Litvinov directs a translational research laboratory within the cancer research program of the MUHC-Research Institute and a hematology-dermatology multidisciplinary clinic at the Glen Site of the MUHC. He also directs a skin cancer diagnosis and treatment clinic for solid organ transplant recipients, and he oversees Projet Soleil UV/SunFit Project. In 2020, Dr Litvinov received the Early Career Award in Cancer from CIHR and the 2019 President Cup Award for his contributions to dermatology and research.

He is married to Dr Elena Netchiporouk, an assistant professor of dermatology and clinician-scientist, who practices at the Montreal General Hospital, McGill University.

Q. What part of your work gives you the most pleasure?
A. I went into medicine to treat patients. I enjoy the balance of having some straightforward cases and several clinics dedicated to complex diseases, such as cutaneous lymphomas. Of course, it is at times challenging to manage advanced Sezary disease since we are lacking effective treatments and have difficulty controlling patient’s itch and other symptoms. What excites me, however, is the fact that over the last 20 years, we have developed many great biologic treatments for previously morbid and deadly diseases (eg, psoriasis, atopic eczema, pemphigus vulgaris, chronic urticaria etc) As a clinician-scientist, I am very excited to be part of the discovery process with several of my translational projects having a strong bench-to-bedside connection. Discovering new information and understanding how it applies to patient care is a true joy. I often say that I am lucky to be receiving a salary for my hobby.

Q. What is the best piece of advice you have received and from whom?
A. I find that the road to success is covered with failures that we continuously must overcome. Often the days get tough, and I look back at some of the accomplishments and say, “Well, I have been here before. If I managed it then, I know I have the skills to manage whatever the difficulties in front of me are now.” I think, ultimately, it was Winston Churchill who summarized it best: “Success is all about going from failure to failure without losing enthusiasm.”

Q. What is the greatest political danger in the field of dermatology?
A. Dermatology is not a monolithic specialty. It is highly dynamic, with many important components that comprise a larger whole: pediatric dermatology, procedural dermatology, Mohs surgery, cosmetic dermatology, rheumatology-dermatology, hematology-dermatology, immunology-dermatology, medical genetics-dermatology, infectious diseases-dermatology, cutaneous oncology, and so on. Each smaller field of practice often interfaces with another medical or surgical subspecialty.

Notably, dermatologists lead research and clinical trials and are widely regarded as the experts in treating psoriasis and other complex autoimmune conditions with anti-TNF-alpha and other biologic medications. On the other hand, we are regrettably not seen as the authority to prescribe immune checkpoint regulatory medications for melanoma, Squamous Cell and Merkel cell carcinomas. Our ability to diagnose and treat complex skin diseases is evolving rapidly and in some of the listed overlapping specialties, we are losing ground. In my opinion, to ensure the respect and long-term sustainability of our specialty, dermatologists must remain innovators and leaders in their respective fields of practice—in academic centers and in community practice. I often give an example of the discovery of ether anesthesia. It is generally credited to Dr William Morton, who was a dentist and not an anesthesiologist! The dentists pioneered the use of this lifesaving treatment in the mid-1800s and were highly respected as the leaders in anesthesia at the time. Hence, as dermatologists we can and should work tirelessly to make discoveries and advances in dermatology and beyond, so as to beneficially impact other fields of medicine that overlap with our specialty. If not, experts in other fields will be taking charge in treating the diseases that fall squarely within our field of expertise.

Q. Who was your hero/mentor and why?
A. My personal hero is Dr Denis Sasseville, my mentor in research and in clinical dermatology. Dr Sasseville trained many prominent Canadian dermatologists and established the field of contact dermatitis in Canada. He is the one who said, “Yes!”, when I asked him for the very first research opportunity in dermatology back in 2006. Since then, we wrote many grants/papers together and co-supervised graduate students and residents. He is always available for advice and encouragement. For any moment that you feel down, he always has a witty joke to cheer you up. By serving in many leadership capacities, he understands where the field needs to go and how to set ambitious yet feasible goals in clinical practice and research. Despite his prominence, he is very humble and treats every person with the utmost respect.

Q. Which medical figure in history would you want to have a drink with and why?
A. Having trained at Johns Hopkins and McGill, the answer is, of course, Sir William Osler. This was an incredible individual who, with his kindness, dedication, and perseverance, revolutionized medicine and in many ways made it what it is today. I remember many days (and nights) studying at the Hopkins medical library staring at The Four Doctors painting of Osler, Kelly, Halsted and Welch. I use as a daily guide many of his sayings. My favorite one is “The best preparation for tomorrow is to do today's work superbly well.”