Dermatology

Dermatology is a division of medicine focused on the diagnosis and treatment of diseases of the skin, hair, nails, and areas such as inside the mouth and nose, which are lined by a mucus membrane. The most common conditions in dermatology include acne, eczema, hair loss, nail fungus, psoriasis, skin cancer, and rosacea. Subspecialties in dermatology include dermatopathology, Mohs surgery, pediatric dermatology, and cosmetic dermatology.

Dermatologists treat diseases and also perform cosmetic procedures. Dermatological treatments include applied and injected medicines, ultraviolet (UV) light therapy, surgical procedures and biopsies, and cosmetic procedures such as chemical peels, sclerotherapy, and laser treatments. Common dermatology procedures include electrosurgery, cryosurgery, laser surgery and excision surgery, Mohs surgery, mole removal, and vein treatment.

Electrosurgery is surgery where tissue is cut or destroyed with high-frequency electric current. Extreme cold is used in cryosurgery to freeze and destroy tissue. Light beams are used in laser surgery. A scalpel is used in excision surgery. A surgical technique involving layer-by-layer removal of cancer cells from the skin is called Mohs surgery. Vein treatment is the repair of damaged veins using sclerotherapy or lasers. Sclerotherapy is a treatment for “spider veins” and varicose veins where a solution is injected into the vein that causes the lining to swell and stick together and later turn into a scar and then visibly fade away.

Telemedicine or e-health is the use of telecommunication technologies for exchanging medical information for the purpose of diagnosis, consultation, therapy, and teaching. Telemedicine in the dermatology field, called teledermatology, increased during the COVID-19 pandemic as a way to reduce the risk of SARS-CoV-2 infections. The two main categories of teledermatology are “Store-and-Forward” (SAF) technology, where clinical images and other information are dispersed and evaluated after a time delay, and teledermatological consultation, which is videoconferencing carried out either directly with patients or between physicians.

Technology advances in computers, smartphones, mobile applications, electronic health records, and electronic prescribing have contributed to the digitization of medicine. Dermatology relies on visual assessments, and advancements in imaging technology have made digital dermatology possible. Smartphone applications used as a diagnostic aid include VisualDx, MyDermPath, and YouDermoscopy. Multispectral digital skin lesion analysis (MSDSLA) is a tool designed to improve diagnostic accuracy and reduce unnecessary biopsies.

Diverse microbes including viruses, fungi, and bacteria cover the surface of the skin and together form the skin microbiota. Microbes can metabolize host proteins and lipids and produce bioactive molecules, cell wall components, and antibiotics. The relationship between human skin and microbes can be mutualistic, where the human host provides nutrients and the microbe promotes homeostasis of the skin and immune system, performs metabolic functions, and helps provide resistance to pathogens. The relationship between the skin and microbes may be pathogenic if the microbe breaches the epithelium or outer layer and causes inflammation. Certain skin pathologies, such as erythrasma, trichomycosis axillaris, and acne are associated with particular microbes. Acne is thought to be caused by a combination of hyperproliferation of cutibacterium acnes and reduction in microbial diversity in the skin microbiome, which is thought to trigger skin inflammation.