A dermatologist is 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 residency 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 (KOH) 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 face peels, hair transplants, injections of materials into the skin for scar revision, sclerosis of veins, and laser surgery of vascular lesions of the skin, including certain birthmarks.
Patients seeking a dermatologist may come directly or may be referred by another physician.
A certified specialist in dermatology may subspecialize and become certified for special qualification as follows:
- Dermatopathology (special qualification in dermatopathology)All dermatologists have training and experience in dermatopathology, however, special qualification in dermatopathology, which signifies 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.
- Immunodermatology (special qualification in dermatological immunology/diagnostic and laboratory immunology)
An immunodermatologist is a dermatologist who, through additional special training, has developed expertise in the study of the cause, diagnosis, treatment, and outcome of skin diseases involving the immune system. These physicians have a basic understanding of such diseases from the perspective of anatomic and clinical pathology, along with the accurate interpretation of immunologic analyses of tissue cells and body fluids. The immunodermatologist is knowledgeable and experienced in utilizing many forms of immunological treatments.
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