Dermatology

Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails. Dermatologists have been leaders in the field of cosmetic surgery. Some dermatologists complete fellowships in surgical dermatology. Many train in their residency on the use of Botox, fillers, and laser surgery. Some dermatologists perform cosmetic procedures including liposuction, blepharoplasty, and face-lifts. Most dermatologists limit their cosmetic practice to minimally invasive procedures. Mohs surgery, developed in the 1930'a y Dr. Frederic E. Mohs, focuses on the excision of skin cancers using a tissue-sparing technique that allows intraoperative assessment of 100% of the peripheral and deep tumor margins . Physicians trained in this technique must be comfortable with both pathology and surgery, and dermatologists receive extensive training in both during their residency. Physicians who perform Mohs surgery can receive training in this specialized technique during their dermatology residency, but many will seek additional training either through preceptorships to join the American Society for Mohs Surgery or through formal one- to two-year Mohs surgery fellowship training programs administered by the American College of Mohs Surgery. Procedural Dermatology is concerned with the study, diagnosis, and surgical treatment of diseases of the skin and adjacent mucous membranes, cutaneous appendages, hair, nails, and subcutaneous tissue. Dermatologic surgical procedures are minimally invasive and may be performed safely in outpatient settings without general anesthesia or other intravascular physiologic alteration. An especially important technique is Mohs micrographic surgical excision, which treats cancers of the skin and incorporates training in clinical dermatology and dermatopathology as they apply to dermatologic surgery. Laser resurfacing is a technique used during laser surgery wherein dissolution of molecular bonds is by laser. It is for the treatment of wrinkles, solar lentigenes, sun damage, scars, stretch marks, actinic keratosis and telangiectasias or "spider veins". It can be with liposuction to remove excess fat from the chin and jaw area. Laser resurfacing can help tighten and smooth over the new contours.