Dermatology is a very small specialty and it's like being in a small town.
Everyone knows everyone else, and they can be very gossipy and clique-ish. Understand that residencies are JOBS. People are initially going to evaluate you based on whether or not they think they can work with you for the next 3-5 years. And like jobs in the real world, it really can be all about who you know.
Stellar CVs are a plus, but if you want a specific residency, make some connections. Befriend the residents, and do a rotation at the program and be a super-star. Finally, spend some serious time with the dermatologists in your community. Find out what connections they have and if they are willing to use them for you.
I speak from experience here. Although I ultimately chose a different area of medicine, I have a lot of connections in Dermatology (I worked at a clinic for 3 years). I was offered an "unofficial position" at two excellent programs (and they said they would put it in writing). I am certainly not top of my class, I intend to be a clinician, I did not ace my boards, and I have never done research.
Good luck with your applications!!