The American Academy of
Dermatology defines a dermatologist as “a
physician who has expertise in the diagnosis and
treatment of pediatric and adult patients with benign
and malignant disorders of the skin, mouth, external
genitalia, hair and nails, as well as a number of
sexually transmitted diseases. Dermatologists have
extensive training and experience in the diagnosis
and treatment of skin cancers, melanomas, moles,
and other tumors of the skin, contact dermatitis and
other allergic and non- allergic disorders and in the
recognition of the skin manifestations of systemic
(including internal malignancy) and infectious
diseases. The dermatologist also has expertise in the
management of cosmetic disorders of the skin such
as hair loss and scars. To be certified as a
dermatologist, a physician must have had at least
four years of post-graduate training accredited by the
Accreditation Council for Graduate Medical Education.
The first broad-based general clinical year is followed
by three years of intensive training in dermatology
including dermatopathology and dermatologic
surgery. In addition to the successful completion of
the four years of required training, the certification
process includes a comprehensive examination
administered by the American Board of Dermatology.
With this background and knowledge, dermatologists
are singularly qualified to diagnose and treat the wide
variety of dermatologic conditions as well as benign
and malignant skin tumors.
Dermatologists also have expertise in the care
of normal skin and in the prevention of skin diseases
and skin cancers. Dermatologists perform many
specialized diagnostic procedures including
microscopic examination of skin biopsy specimens,
cytological smears, patch tests, photo tests, potassium hydroxide preparations, fungus cultures
and other microbiologic examination of skin scrapings
and secretions. Treatment methods used by
dermatologists include externally applied, injected,
and internal medications, selected x-ray and
ultraviolet light therapy, and a range of dermatologic
surgical procedures. The training and experience of
dermatologists in dermatologic surgery include
electrosurgery, cryosurgery with the use of freezing
surgical units, laser surgery; nail surgery, biopsy
techniques and excisional surgery with appropriate
closures, including flaps and grafts. Among some of
the techniques used by dermatologists for the
correction of cosmetic defects are dermabrasion,
chemical peels, hair transplants, injections of filler
materials into the skin for scar revision,
sclerotherapy, and many different laser therapies.
Patients seeking a dermatologist may come directly
or may be referred by another physician.” This
definition and additional information regarding
dermatology as a specialty can be viewed on the
American Academy of Dermatology web site:
www.aad.org
A certified specialist in dermatology may sub specialize and become certified for Special Qualification as in Dermatopathology and indicates this subspecialty by the phrase “Special Qualification in Dermatopathology” The American Academy of Dermatology states “While all dermatologists have training and experience in dermatopathology, Special Qualification in Dermatopathology, signifying advanced competence, can be obtained by either a board certified dermatologist or pathologist. Special Qualification involves further extensive training and experience in the evaluation of tissue specimens submitted from dermatologic patients. These evaluations include the examination and interpretation of microscopic slides of thin tissue sections and smears, and scrapings from lesions of skin and related tissues. The dermatopathologist has expertise in light and electron microscopy, immunohistochemistry, and laboratory management.”
Why should I see a Dermatologist?
When a Dermatologist examines a patient,
he brings to that examination not only his expertise
in physical assessment, but also unique insight from
his specialized training on the cellular alterations
(histology) of skin disorders (dermatopathology).
Very often, he will biopsy the condition to correlate
the physical findings with the histological changes of
the disorder at the time of the visit before
recommending treatment. This allows the
dermatologist the opportunity to tailor treatment
specifically to each patient’s unique problems and
eliminates time and money wasted on ineffective
treatments. No other specialist, internist or general
practitioner can bring this dual expertise into the
exam room. Furthermore, some family doctors will
treat the condition first and refer the patient to a
dermatologist only after treatment has been
unsuccessful. However, once a condition has been
treated, the clinical presentation can change, and
unsuccessful treatment can complicate and/or
prolong successful treatment. Therefore, it is cost
effective of both time and money to see a
dermatologist initially for evaluation of your skin
disorder. This cost savings is confirmed by at least
one major California HMO that, in recent years, has
relaxed referral requirements to allow patients to self
refer to dermatologists.
