Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseasesRandom House Webster's Unabridged Dictionary. Random House, Inc. 2001. Page 537. ISBN 037572026., a unique specialty with both medical and surgical aspects.http://dermnetnz.org/dermatologist.htmlhttp://www.aad.org/public/specialty/what.htmlhttp://www.dermcoll.asn.au/public/what_is_a_dermatologist.asp A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails.
Etymology
Coined in English 1819, the word dermatology originated in the form of the words dermologie (in French, 1764) and, a little later, dermatologia (in Latin, 1777).Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill Professional. Page 3. ISBN 0071380760. The term derives from the Greek "δέρματος" (dermatos), genitive of "δέρμα" (derma), "skin" δέρμα, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library (from "δέρω" - dero, "to flay" δέρω, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library) + " -logy, "the study of", a suffix derived from "λόγος" ( logos), amongst others meaning "speech, oration, discourse, quote, study, calculation, reason", λόγος, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library in turn from "λέγω" - lego, "to say", "to speak". λέγω, Henry George Liddell, Robert Scott, An Intermediate Greek-English Lexicon, on Perseus Digital LibraryHistory
Readily visible alterations of the skin surface have been recognized since the dawn of history, with some being treated, and some not. In 1801 the first great school of dermatology became a reality at the famous Hôpital Saint-Louis in Paris, while the first textbooks (Willan's, 1798–1808) and atlases ( Alibert's, 1806–1814) appeared in print during the same period of time. In 1952, Dermatology was greatly advanced by Dr. Norman Orentreich's pioneering work in hair transplantation.Training
After earning a medical degree (M.D. or D.O.), the length of training for a general dermatologist in the United States is a total of four years. This training consists of an initial medical or surgical intern year followed by a three-year dermatology residency.http://www.abderm.org/residency.htmlhttp://www.aocd.org/qualify/board_certification.html Following this training, one- or two- year post-residency fellowships are available in immunodermatology, phototherapy, laser medicine, Mohs micrographic surgery, cosmetic surgery or dermatopathology. Within the past several years, dermatology residencies in the United States have been the most competitive in terms of admission.Subspecialties
Cosmetic dermatology
Dermatologists have been leaders in the field of cosmetic surgery.James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. Page 895. ISBN 0721629210. Some dermatologists complete fellowships in surgical dermatology. Many are trained in their residency on the use of botox, fillers, and laser surgery. Some dermatologists perform cosmetic procedures including liposuction, blepharoplasty, and face lifts.http://www.derm.net/sv_cosmetic_surgery.shtmlhttp://www.daytonskinsurgery.org/fellowship.htmlhttp://www.ucdmc.ucdavis.edu/dermatology/education/fellowship.html Most dermatologists limit their cosmetic practice to minimally invasive procedures. Despite an absence of formal guidelines from the American Board of Dermatology, many cosmetic fellowships are offered in both surgery and laser medicine.Dermatopathology
A dermatolopathologist is a pathologist or dermatologist who specializes in the pathology of the skin. This field is shared by dermatologists and pathologists. Usually a dermatologist or pathologist will complete one year of dermatopathology fellowship. This usually includes six months of general pathology, and six months of dermatopathology.uwpathology.org/academics/residency/fellowship/DermGoals.pdf Alumni of both specialties can qualify as dermatopathologists. At the completion of a standard residency in dermatology, many dermatologists are also competent at dermatopathology. Some dermatopathologists qualify to sit for their examinations by completing a residency in dermatology and one in pathology.http://www.abderm.org/qualification.htmlImmunodermatology
This field specializes in the treatment of immune-mediated skin diseases such as lupus, bullous pemphigoid, pemphigus vulgaris, and other immune-mediated skin disorders.http://www.mayo.edu/msgme/immunderm-rch.html Specialists in this field often run their own immunopathology labs.Mohs surgery
The dermatologic subspecialty called Mohs surgery 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 developed in the 1930s by Dr. Frederic E. Mohs. The procedure is defined as a type of CCPDMA processing. 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 Surgeryhttp://www.mohssurgery.org/New/Patient_publicResources/PhysicianTraining.html or through formal one- to two-year Mohs surgery fellowship training programs administered by the American College of Mohs Surgeryhttp://www.mohscollege.org/acms/difference.php.Pediatric dermatology
Physicians can qualify for this specialization by completing both a pediatric residency and a dermatology residency. Or they might elect to complete a post-residency fellowship.http://www.abderm.org/subspecialties/pediatric.htm This field encompasses the complex diseases of the neonates, hereditary skin diseases or genodermatoses, and the many difficulties of working with the pediatric population.Teledermatology
Teledermatology is a form of dermatology where telecommunication technologies are used to exchange medical information via all kinds of media (audio, visual and also data communication, but typically photos of dermatologic conditions) usually made by non-dermatologists for evaluation off-site by dermatologists).Burg G, Soyer H.P, Chimenti S. (2005): Teledermatology In: Frisch P, Burgdorf W.: EDF White Book, Skin Diseases in Europe. Berlin, 130-133Douglas A. Perednia, M.D., Nancy A. Brown, M.L.S., OregonHealthSciencesUniversity Teledermatology: one application of telemedicine This subspecialty deals with options to view skin conditions over a large distance to provide knowledge exchange DermNet NZ: the dermatology resource, to establish second-opinion services for experts The Community for Dermatology | Teledermatology or to use this for follow-up of individuals with chronic skin conditionsEbner et al. 2006 e&iH. Peter Soyer, Rainer Hofmann-Wellenhof, Cesare Massone, Gerald Gabler, Huiting Dong, Fezal Ozdemir, Giuseppe Argenziano telederm.org: Freely Available Online Consultations in Dermatology.Therapies
Therapies provided by dermatologists include, but not restricted to:- Cosmetic filler injections
- Hair removal with laser or other modalities
- Hair transplantation - a cosmetic procedure practiced by many dermatologists.
- Intralesional treatment - with steroid or chemotherapy.
- Laser therapy - for both the management of birth marks, skin disorders (like vitiligo), tattoo removal, and cosmetic resurfacing and rejuvenation.
- Photodynamic therapy - for the treatment of skin cancer and precancerous growths.
- Phototherapy - including the use of narrowband UVB, broadband UVB, psoralen and UVB.
- Tattoo removal with laser
- Tumescent liposuction - liposuction was invented by a gynecologist. A dermatologist (Dr. Jeffrey A. Klein) adapted the procedure to local infusion of dilute anesthetic called tumescent liposuction. This method is now widely practiced by dermatologists, plastic surgeons and gynecologists.http://inventors.about.com/od/lstartinventions/a/liposuction.htm
- Cryosurgery - for the treatment of warts, skin cancers, and other dermatosis.
- Radiation therapy - although rarely practiced by dermatologists, many dermatologist continue to provide radiation therapy in their office.
- Systemic therapies - including antibiotics, immunomodulators, and novel injectable products.
- Topical therapies - dermatologists have the best understanding of the numerous products and compounds used topically in medicine.