Dermatology is the branch of medicine dealing with the skin The skin is a soft outer covering of an animal, in particular a vertebrate. Other animal coverings such the arthropod exoskeleton or the seashell have different developmental origin, structure and chemical composition. The adjective cutaneous literally means "of the skin" . In mammals, the skin is the largest organ of the integumentary and its diseases There are many conditions of or affecting the human integumentary system—the organ system that covers the entire surface of the body and is composed of skin, hair, nails, and related muscle and glands^[1], a unique specialty with both medical and surgical aspects.^[2][3][4] A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails.^[3]

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).^[5] The term derives from the Greek Greek , an independent branch of the Indo-European family of languages, is the language of the Greeks. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. In its ancient form, it is the language of classical ancient Greek literature and the New Testament of "δέρματος" (dermatos), genitive of "δέρμα" (derma), "skin"^[6] (from "δέρω" - dero, "to flay"^[7]) + "-logy -logy is a suffix in the English language, used with words originally adapted from Ancient Greek language ending in -λογία . The earliest English examples were anglicizations of the French -logie, which was in turn inherited from the Latin -logia, "the study of", a suffix derived from "λόγος" (logos Logos is an important term in philosophy, analytical psychology, rhetoric and religion. Originally a word meaning "word," "speech," "account," or "reason," it became a technical term in philosophy, beginning with Heraclitus (ca. 535–475 BC), who used the term for the principle of order and knowledge in the), amongst others meaning "speech, oration, discourse, quote, study, calculation, reason",^[8] in turn from "λέγω" - lego, "to say", "to speak".^[9]

History

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 Hôpital Saint-Louis is a hospital in Paris, France. It is part of the Assistance publique - Hôpitaux de Paris hospital system, and it is located at 1 avenue Claude-Vellefaux, in the 10th arrondissement, near the metro station: Goncourt in Paris, while the first textbooks (Willan's, 1798–1808) and atlases (Alibert's Jean-Louis-Marc Alibert was a French dermatologist born in Villefranche-de-Rouergue, Aveyron. He was a pioneer of French dermatology, 1806–1814) appeared in print during the same period of time.^[5] In 1952, Dermatology was greatly advanced by Dr. Norman Orentreich Norman Orentreich is a pioneering New York dermatologist and the father of modern hair transplantation. Orentreich created Estee Lauder's Clinique line of skin care products, invented numerous dermatologic procedures and was the first president of the American Society for Dermatologic Surgery. He is the founder of the Orentreich Medical Group and'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.^[3][10][11] Following this training, one- or two- year post-residency fellowships are available in immunodermatology Immunodermatology studies skin as an organ of immunity in health and disease. Several areas have special attention, such as photo-immunology , inflammatory diseases such as allergic contact dermatitis and atopic eczema, presumably autoimmune skin diseases such as vitiligo and psoriasis, and finally the immunology of microbial skin diseases such as, phototherapy Light therapy or phototherapy consists of exposure to daylight or to specific wavelengths of light using lasers, light-emitting diodes, fluorescent lamps, dichroic lamps or very bright, full-spectrum light—by a so-called light box. The light is administered for a prescribed amount of time and, in some cases, at a specific time of day. Light, laser medicine Laser medicine is the use of various types of lasers in medical diagnosis, treatment, or therapy. Types of lasers used in medicine include in principle any laser design, especially:, Mohs micrographic surgery Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is microscopically controlled surgery used to treat common types of skin cancer. It is one of the many methods of obtaining complete margin control during removal of a skin cancer using frozen section histology. CCPDMA or Mohs surgery allows for the, cosmetic surgery Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns. The word "plastic" derives from the Greek plastikos meaning to mould or or dermatopathology Dermatopathology is a subspecialty of dermatology and surgical pathology that consist in the study of skin disease at a microscopic level. It encompasses both the diagnosis of individual patients through the examination of skin biopsies, and the study of the causes, or pathogenesis of skin diseases at the cellular level. Dermatopathologists work. Within the past several years, dermatology residencies in the United States have been the most competitive in terms of admission.^[12][13][14]

Subspecialties

Cosmetic dermatology

Dermatologists have been leaders in the field of cosmetic surgery.^[15] Some dermatologists complete fellowships in surgical dermatology. Many are trained in their residency on the use of botox Botulinum toxin is a medication and a neurotoxic protein produced by the bacterium Clostridium botulinum, and is known to be very toxic with an LD50 of roughly 0.005–0.05 µg/kg. Despite its deadly toxic effect, it is sometimes used in very small doses to treat muscle spasms. Popularly known by its trade name, Botox, botulinum toxin is now, fillers, and laser surgery. Some dermatologists perform cosmetic procedures including liposuction Liposuction, also known as lipoplasty , liposculpture suction lipectomy or simply lipo ("suction-assisted fat removal") is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere, blepharoplasty Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery, and face lifts A facelift, technically known as a rhytidectomy , is a type of cosmetic surgery procedure used to give a more youthful appearance. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. The first facelift was performed in Berlin in 19.^[16][17][18] Most dermatologists limit their cosmetic practice to minimally invasive procedures. Despite an absence of formal guidelines from the American Board of Dermatology The American Board of Dermatology , located in Detroit, MI, certifies physicians in dermatology, dermatopathology and pediatric dermatology. Certified physicians are known as diplomates and may represent themselves to the public as “board-certified”. Since its inception in 1932, the ABD has certified over 13,000 physicians. The ABD was one of, many cosmetic fellowships are offered in both surgery and laser medicine.^{[citation needed]}

Dermatopathology

A dermatolopathologist is a pathologist In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology." Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies or dermatologist who specializes in the pathology In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology". Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies 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.^[19] 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.^[20]

Immunodermatology

This field specializes in the treatment of immune-mediated skin diseases such as lupus Systemic lupus erythematosus (pronounced /sɨˈstɛmɨk ˈluːpəs ˌɛrɨˌθiːməˈtoʊsəs/ , often abbreviated to SLE or lupus, is a chronic autoimmune connective tissue disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and, bullous pemphigoid Bullous pemphigoid, also referred to as BP, is an acute or chronic autoimmune skin disease, involving the formation of blisters, more appropriately known as bullae, at the space between the skin layers epidermis and dermis, pemphigus vulgaris Pemphigus vulgaris is a chronic blistering skin disease with skin lesions that are rarely pruritic, but which are often painful.:561, and other immune-mediated skin disorders.^[20][21] Specialists in this field often run their own immunopathology labs.^{[citation needed]}

Mohs surgery

The dermatologic subspecialty called Mohs surgery Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is microscopically controlled surgery used to treat common types of skin cancer. It is one of the many methods of obtaining complete margin control during removal of a skin cancer using frozen section histology. CCPDMA or Mohs surgery allows for the 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 Surgery^[22] or through formal one- to two-year Mohs surgery fellowship training programs administered by the American College of Mohs Surgery^[23].

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.^[24] This field encompasses the complex diseases of the neonates The term infant derives from the Latin word infans, meaning "unable to speak or speechless" It is typically applied to children between the ages of 1 month and 12 months; however, definitions vary between birth and 3 years of age, hereditary skin diseases or genodermatoses Congenital ichthyosiform erythroderma: Epidermolytic hyperkeratosis · Lamellar ichthyosis , and the many difficulties of working with the pediatric Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. The upper age limit of such patients ranges from age 12 to 21. A medical practitioner who specializes in this area is known as a pediatrician. The word pediatrics and its cognates mean healer of children; they derive from two Greek words: π population.^{[citation needed]}

Teledermatology

Teledermatology Teledermatology is a subspecialty in the medical field of dermatology and probably one of the most common applications of telemedicine and e-health. In teledermatology, telecommunication technologies are used to exchange medical information over a distance using audio, visual and data communication. Applications comprise health care management 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).^[25][26] This subspecialty deals with options to view skin conditions over a large distance to provide knowledge exchange^[27], to establish second-opinion services for experts^[28] or to use this for follow-up of individuals with chronic skin conditions^[29][30].

Therapies

Therapies provided by dermatologists include, but not restricted to:

• Cosmetic filler injections
• Hair Hair is a filamentous biomaterial, that grows from follicles found in the dermis. The human body, apart from the palms of the hands and soles of the feet, is covered in follicles which produce thick terminal and fine vellus hair. Most common interest in hair is focused on hair growth, hair types and hair care but hair is also an important removal with laser or other modalities
• Hair transplantation - a cosmetic procedure practiced by many dermatologists.
• Intralesional treatment - with steroid or chemotherapy Chemotherapy, in its most general sense, is the treatment of disease by chemicals especially by killing micro-organisms or cancerous cells. In popular usage, it refers to antineoplastic drugs used to treat cancer or the combination of these drugs into a cytotoxic standardized treatment regimen. In its non-oncological use, the term may also refer.
• 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 Skin neoplasms are growths on the skin which can have many causes. The three most common skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises. Skin cancer generally develops in the epidermis , so a tumor is usually clearly visible. This makes most skin and precancerous growths.
• Phototherapy Light therapy or phototherapy consists of exposure to daylight or to specific wavelengths of light using lasers, light-emitting diodes, fluorescent lamps, dichroic lamps or very bright, full-spectrum light—by a so-called light box. The light is administered for a prescribed amount of time and, in some cases, at a specific time of day. Light - including the use of narrowband UVB, broadband UVB, psoralen and UVB.
• Tattoo A tattoo is a marking made by inserting dark, indelible ink into the dermis layer of the skin to change the pigment for decorative or other reasons. Tattoos on humans are a type of decorative body modification, while tattoos on animals are most commonly used for identification or branding. The term "tattoo" or from Samoa, "Tatau& removal with laser
• Tumescent liposuction Liposuction, also known as lipoplasty , liposculpture suction lipectomy or simply lipo ("suction-assisted fat removal") is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere - liposuction was invented by a gynecologist Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women". It is the counterpart to andrology, which deals with medical issues specific to the male reproductive system. A dermatologist (Dr. Jeffrey A. Klein Klein studied mathematics and physics as an undergraduate at the University of California, Riverside . As a graduate student, he studied mathematics at the Université de Paris and University of California, San Diego (MA in mathematics, 1971). He graduated from the School of Medicine, University of California, San Francisco in 1976 and spent eight) adapted the procedure to local infusion of dilute anesthetic called tumescent liposuction. This method is now widely practiced by dermatologists, plastic surgeons and gynecologists.^[31]
• Cryosurgery Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The term comes from the Greek words cryo (κρύο) ("icy cold") and surgery (cheirourgiki - χειρουργική) meaning "hand work" or "handiwork". Cryosurgery has been historically used to treat a number of diseases and - for the treatment of warts, skin cancers, and other dermatosis.
• Radiation therapy Radiation therapy , or radiotherapy (in the UK and Australia) also called radiation oncology, and sometimes abbreviated to XRT, is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Radiotherapy may be used for - 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.

Most dermatologic pharmacology can be categorized based on the Anatomical Therapeutic Chemical Classification System The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. It is controlled by the WHO Collaborating Centre for Drug Statistics Methodology (WHOCC), and was first published in 1976, specifically the ATC code D ATC code D Dermatologicals is a section of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the WHO for the classification of drugs and other medical products.

See also

• History of dermatology Readily visible alterations of the skin surface have been recognized since the dawn of history, with some being treated, and some not. Avicenna's The Canon of Medicine described treatments for a variety of skin conditions, including skin cancer. The preferred medication it recommended was zinc oxide. Though today it is no longer used for treating
• List of dermatologists Categories: Dermatologists | Lists of health professionals |
• List of skin diseases There are many conditions of or affecting the human integumentary system—the organ system that covers the entire surface of the body and is composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier against the external environment. The skin weighs an average of four kilograms, covers an area
• Skin disease There are many conditions of or affecting the human integumentary system—the organ system that covers the entire surface of the body and is composed of skin, hair, nails, and related muscle and glands
• Skin lesion There are many conditions of or affecting the human integumentary system—the organ system that covers the entire surface of the body and is composed of skin, hair, nails, and related muscle and glands

Notes

1. ^ Random House Webster's Unabridged Dictionary. Random House, Inc. 2001. Page 537. ISBN 037572026.
2. ^ http://dermnetnz.org/dermatologist.html
3. ^ ^{a b c} http://www.aad.org/public/specialty/what.html
4. ^ http://www.dermcoll.asn.au/public/what_is_a_dermatologist.asp
5. ^ ^{a b} Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill Professional. Page 3. ISBN 0071380760.
6. ^ δέρμα, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library
7. ^ δέρω, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library
8. ^ λόγος, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library
9. ^ λέγω, Henry George Liddell, Robert Scott, An Intermediate Greek-English Lexicon, on Perseus Digital Library
10. ^ http://www.abderm.org/residency.html
11. ^ http://www.aocd.org/qualify/board_certification.html
12. ^ ""...has been the most competitive of all specialties for at least the last 5-6 years." This is confirmed by data from the electronic residency application service (ERAS).". http://dermatology.cdlib.org/93/editorial/residency/wu2.html. Retrieved 2007-06-23.
13. ^ ""Dermatology continues to be the most competitive residency to enter..." Arch Dermatol. 2006;142:845-850.". http://archderm.ama-assn.org/cgi/content/full/142/7/845. Retrieved 2007-06-25.
14. ^ Singer, Natasha (2008-03-19). ""For Top Medical Students, an Attractive Field"". The New York Times. http://www.nytimes.com/2008/03/19/fashion/19beauty.html?_r=1&hp=&pagewanted=print&oref=slogin. Retrieved 2010-05-01.
15. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. Page 895. ISBN 0721629210.
16. ^ http://www.derm.net/sv_cosmetic_surgery.shtml
17. ^ http://www.daytonskinsurgery.org/fellowship.html
18. ^ http://www.ucdmc.ucdavis.edu/dermatology/education/fellowship.html
19. ^ uwpathology.org/academics/residency/fellowship/DermGoals.pdf
20. ^ ^{a b} http://www.abderm.org/qualification.html
21. ^ http://www.mayo.edu/msgme/immunderm-rch.html
22. ^ http://www.mohssurgery.org/New/Patient_publicResources/PhysicianTraining.html
23. ^ http://www.mohscollege.org/acms/difference.php
24. ^ http://www.abderm.org/subspecialties/pediatric.htm
25. ^ Burg G, Soyer H.P, Chimenti S. (2005): Teledermatology In: Frisch P, Burgdorf W.: EDF White Book, Skin Diseases in Europe. Berlin, 130-133
26. ^ Douglas A. Perednia, M.D., Nancy A. Brown, M.L.S., OregonHealthSciencesUniversity Teledermatology: one application of telemedicine
27. ^ DermNet NZ: the dermatology resource
28. ^ The Community for Dermatology | Teledermatology
29. ^ Ebner et al. 2006 e&i
30. ^ H. Peter Soyer, Rainer Hofmann-Wellenhof, Cesare Massone, Gerald Gabler, Huiting Dong, Fezal Ozdemir, Giuseppe Argenziano telederm.org: Freely Available Online Consultations in Dermatology
31. ^ http://inventors.about.com/od/lstartinventions/a/liposuction.htm

External links

• American History of Dermatology Society
• French Society for the History of Dermatology
• American Academy of Dermatology
• Society of Investigative Dermatology

Categories: Dermatology | Subjects taught in medical school | Greek loanwords

See Also:

• Dermatology: Encyclopedia
• Geriatrics Dermatology: Encyclopedia

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