Dermatology

Dermatology is the medical speciality that deals with disorders and diseases (including cancers of the skin.) It also deals with disorders of hair, nails and mucous membranes.

A dermatologist is a medical specialist in dermatology.

The earliest treatment of skin conditions can be found in writings in ancient history. The ancient Egyptians treated the skin with various chemicals to try to achieve various medicinal and cosmetic results. The physician Avicenna wrote “The Canon of Medicine,” which was published in 1025 and this described treatments for a number of skin conditions, including skin cancer. It was not until the early part of the 19th Century that the skin was studied in a more methodical way, with some physicians becoming interested in skin diseases and then naming and cataloguing them. It was only later in this Century that these physicians actually began to call themselves dermatologists. One of the early text books of dermatology was written by Dr Robert Willan. In 1808, he wrote his treatise “On Cutaneous Diseases”, which is a remarkable attempt to describe, illustrate and classify skin diseases in a systematic manner. Willan had been inspired by the early taxonomist, Carl Linnaeus, who had catalogued and named much of the plant and animal kingdoms. Linnaeus, of course, laid the foundations for modern binomial nomenclature in biology.

Skin diseases are surprisingly prevalent. A very large study was performed in the early 1970’s in the United States. This was known as the United States’ Health and Nutritional Examination Survey (HANES), and more than 20,000 individuals were examined by dermatologists. In the HANES study, nearly one third of those examined had at least one or more skin condition that the dermatologists considered significant. The patients examined were thought to be representative of the United States’ population as a whole. This would equate to a huge burden of significant pathology. A similar study, in Lambeth in London in the mid 1970’s and this showed that the overall prevalence of skin disease thought to justify care was 22.5%. In general practice, anywhere from 10 to 15% of consultations involve a dermatological problem. Something that often surprises people is how much disability can be associated with skin conditions, particularly chronic diseases such as atopic dermatitis and psoriasis. Some patients with severe skin disorders have been assessed as having measures of disability comparable to patients with congestive heart failure. Any dermatologist will have seen the despair written on the faces of adolescents who have extremely severe nodulocystic acne or in patients covered with a disfiguring skin disease.

Studies also show that dermatologists, rather than other doctors, are perhaps not surprisingly more likely to make a successful diagnosis of skin conditions and more likely to offer treatment that is helpful. Not everyone knows what a dermatologist is or does however. A recent survey in the United States showed that around 15% of the population was unaware that a dermatologist was even medically qualified, let alone a specialist. It is probable the same results would be found in Australasia or the United Kingdom.

Dermatology has increased its scope in recent decades. There has been a huge burgeoning of scientific research and this has led to a new understanding of many different skin diseases and has led to promising new treatments. The surgical management of skin cancer has become more sophisticated and diagnostic techniques for skin cancer have also improved. There has been a growing interest in cosmetic treatment for patients with normal and ageing skin. There is no doubt that in the future, more treatments for more conditions will be available and cosmetic treatments will become increasingly more sophisticated.