Current issues in dermatologic office-based surgery

Dermatologists and dermatologic surgeons have played major roles in the dev elopment and refinement of many office-based cutaneous surgical procedures. The comprehensive scientific education in the structure and function of sk in that dermatologists receive during formal residency training programs ha s contributed directly to these advances. This long tradition of comprehens ive training and strong basic research activities in skin biology has suppo rted a scholarly approach to cutaneous surgery. As a result, many pioneerin g cutaneous surgical techniques have been created by dermatologists and der matologic surgeons. One example of this creativity can be seen in the field of laser surgery where techniques to effectively treat tattoos, benign pig mented lesions, port-wine stains and other vascular conditions, premalignan t and malignant skin lesions, wrinkles and sun-damaged skin, and excess or unwanted hair were developed by dermatologists. Some of the most innovative procedures, like tumescent liposuction, have focused primarily on improvin g patient safety while preserving the highest standards of care. Virtually every aspect of cutaneous surgery, including Mohs micrographic surgery for the treatment of skin cancers, hair replacement surgery, sclerotherapy of l eg veins, the correction of scars and sun-damaged skin with the injection o f filler materials, dermabrasion or chemical peels, and new anesthesia tech niques, have been favorably impacted by the unique education and skills of many dermatologists and dermatologic surgeons. This article reviews the imp ortant historic role that has been played by dermatologists and dermatologi c surgeons in developing and improving outpatient cutaneous surgical proced ures and examines current issues and future directions in credentialing, pr ivileging, and accreditation.