Dr. Botto has an active clinical practice in general dermatology and a special interest in allergic contact dermatitis. She is the co-director of the Occupational and Contact Dermatitis Clinic, where she brings her expertise in contact dermatitis to patients referred for patch testing and complex inflammatory dermatoses. She serves on the board of the American Contact Dermatitis Society. In her general dermatology outpatient clinic, she sees patients with all types of skin disease including skin cancer, inflammatory skin diseases, and acne, amongst others.

In addition to her dermatologic academic pursuits, Dr. Botto believes that the relationship between the patient and provider is of vital importance to healing and optimized care. She is interested in enhancing the patient experience. She has organized and led efforts focused on service excellence within the Dermatology Department, and is a member of UCSF's CECH organization, which focuses on improving communication skills among providers throughout the University to better healthcare experiences for patients, families and the healthcare team.