Dermatosurgery | Specialists and Information

Dermatosurgery involves the removal of malignant tumors in cases of skin cancer. Dermatosurgeons also treat benign tumors, scars, and skin lesions.

The procedure is performed surgically.

Treatment with medications or ointments does not fall within the scope of dermatological surgery.

There isn’t always a medical indication for surgery: skin surgeries can also be performed for cosmetic reasons at the patient’s request. For example, dermatologic surgeons remove congenital pigmented lesions that are harmless but which patients find bothersome.

Skin cancer can manifest in a variety of forms @ Pixel-Shot /AdobeStock

The range of treatments in dermatosurgery is broad and encompasses a wide variety of procedures. Tumors can occur on any part of the body. Surgeries on the face, neck, and back of the hands present a particular challenge.

There is little “skin reserve” in these areas. The surgeon must therefore operate with extreme precision.

The following surgeries are performed most frequently:

• Removal of benign and malignant skin tumors, such as melanoma and basal cell carcinoma
• Skin cancer surgeries
• Removal of moles
• Tattoo removal
• Scar revision
• Removal of sweat gland abscesses
• Removal of a bulbous nose
• Coccygeal fistula removal

Tattoo removal also falls within the field of dermatological surgery @ venusvi /AdobeStock

The surgeon performs the procedure on an outpatient or inpatient basis. General anesthesia or local anesthesia may be used, depending on the type and extent of the condition.

When removing tumors, a microscopically guided procedure is used. In this type of surgery, the surgeon first removes the tumor.

A histopathologist then examines the excised tumor in the laboratory. If tumor margins are found at the surgical margins, the surgeon performs a second procedure.

Only then does the surgeon close the wound with the utmost precision to ensure an aesthetically pleasing result. This type of surgery ensures optimal removal of the tumor as well as a clean wound closure. The surgeon spares the surrounding tissue and completely removes the malignant tumor tissue.

Dermatological surgical procedures are minimally invasive. This enables doctors to remove scars and keloids (raised scars). Thanks to precise incisions and modern suturing techniques, the surgeon removes unsightly scars. He ensures that scarring is as discreet as possible.

If the doctor removes a large amount of tissue, skin flaps and skin grafts may be used. Scar care is particularly important in the first few weeks after surgery.

The patient must not put strain on the scar and must care for it with special creams. In addition, patients should avoid direct sunlight and refrain from smoking after the procedure.

In the field of dermatological surgery, doctors also use the following treatment methods:

• Laser
• Cryosurgery (destruction of tissue using extreme cold)
• Skin resurfacing (microdermabrasion)
• Chemical peels 
• Suction methods

In dermatosurgery—just as in dermatology—a visual diagnosis is usually performed first. The doctor determines the nature of the condition based on skin changes. The doctor may also palpate the skin. To make an accurate diagnosis, the surgeon typically uses a microscope.

Histological findings play an important role. These are obtained after the tumor has been excised. A specialist examines tissue samples under a microscope to determine the nature of the condition. Histology is important because it helps determine whether the condition is an inflammation or a tumor.

If a tumor is suspected, the treating physician will use the following diagnostic methods:

• Ultrasound
• X-ray
• Computed tomography or
• Magnetic resonance imaging

These are imaging techniques that help the doctor determine whether the tumor has spread throughout the body.

Tumor markers in the blood can also indicate the presence of cancer.

Patients can find a suitable doctor through the German Society for Dermatological Surgery (DGDC). Many dermatosurgeons work in clinics or hospitals, while others practice in private practice. Since dermatosurgery is a diverse field of medicine, the specific focus varies from doctor to doctor.

Dermatosurgery is a subspecialty of dermatology. It overlaps significantly with the field of plastic and aesthetic medicine.

Dermatosurgeons specialize in the surgical removal of various skin lesions.

The primary focus is clearly on the surgical removal of malignant tumors. However, dermatological surgery goes much further and also treats benign tumors, warts, scars, moles, and other skin problems.

Depending on the condition, the doctor performs the surgery on an inpatient or outpatient basis. In dermatological surgery, precision is of the utmost importance to ensure that tumors are removed cleanly.

Dermatologic surgeons work in private practice as well as in clinics and hospitals. Patients can find a doctor through the German Society for Dermatologic Surgery or contact a clinic.