Current issues in dermatologic office-based surgery

Dermatologists anti dermatologic surgeons have played major roles in the de velopment and refinement of many office-based cutaneous surgical procedures . The comprehensive scientific education in the structure and function of s kin that dermatologists receive during formal residency training programs h as contributed directly to these advances. This long tradition of comprehen sive training and strong basic research activities in skin biology has supp orted a scholarly approach to cutaneous surgery. As a result, many pioneeri ng cutaneous surgical techniques have been created by dermatologists and de rmatologic surgeons. One example of this creativity can be seen in the fiel d of laser surgery, in which techniques to effectively treat tattoos, benig n pigmented lesions, port-wine stains and other vascular conditions, premal ignant and malignant skin lesions, wrinkles and sun-damaged skin, and exces s or unwanted hair were developed by dermatologists. Some of the most innov ative procedures, like tumescent liposuction, have focused primarily on imp roving patient safety while preserving the highest standards of care. Virtu ally every aspect of cutaneous surgery, including Mohs micrographic surgery for the treatment of skin cancers, hair replacement surgery sclerotherapy of leg veins, the correction of scars and sun-damaged skin with the injecti on of filler materials, dermabrasion or chemical peels, and new anesthesia techniques, have been favorably affected by the unique education and skills of many dermatologists and dermatologic surgeons. This article reviews the important historic role that has been played by dermatologists and dermato logic surgeons in developing and improving outpatient cutaneous surgical pr ocedures and examines current issues and future directions in credentialing , privileging, and accreditation.