"चर्मविज्ञान" का संशोधनहरू बिचको अन्तर

'''Dermatology''' (from Greek ''derma,'' "skin") is a branch of [[medicine]] dealing with the [[skin]] andर its appendages (hair, nails, sweat glands etc). A medical doctor who specializes in dermatology is a '''dermatologist'''.

'''Dermatologists''' are physicians (medical doctors) specializing in the diagnosis andर treatment of diseases andर tumors of the skin andर its appendages. There are medical andर surgical sides to the specialty. [[Dermatologic Surgeon|Dermatologic surgeon]]s practice skin cancer surgery (including Mohs' micrographic surgery), laser surgery, photodynamic therapy (PDT) andर cosmetic procedures using botulinum toxin ('Botox'), soft tissue fillers, sclerotherapy andर liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses andर treatment of skin disease in children. Immunodermatologists specialize in the diagnosis andर management of skin diseases driven by an altered immune system including blistering (bullous) diseases like pemphigus. In addition, there are a wide range of congenital syndromes managed by dermatologists.

A minimum of 12 years of college andर post graduate training is required to become a dermatologist in the United States andर Canada. This includes graduation from a 4-year college, a 4-year medical school followed by a year of post graduate training in medicine, surgery or pediatrics (called an [[medical intern|internship]]) after which a physician may apply for admission to graduate dermatology [[residency (medicine)|residency]] training. Dermatology residencies are among the most competitive. Following the successful completion of formal residency training in dermatology (3 years) the physician is qualified to take certifying board examinations (written andर oral) by the American Board of Dermatology or the American Osteopathic College of Dermatology. Once board certified, dermatologists become Diplomates of the American Board of Dermatology or the American Osteopathic College of Dermatology [http://www.aocd.org AOCD]. They are then eligible to apply for fellowship status in the [http://www.aad.org/default.htm American Academy of Dermatology]. Some dermatologists undertake advanced subspecialty training in programs known as fellowships after completion of their residency training. These fellowships are either one or two years in duration. Fellowships in dermatology include pediatric dermatology, surgical dermatology including MOHS micrographic surgery, dermatopathology (pathology of skin diseases) andर dermatological immunology.

An Australian specialist dermatologist will have completed 6 years of medical school, one [[medical intern|internship]] year andर at least one year of general medical or surgical service in the public hospital system, prior to becoming eligible for specialist training in dermatology. The selection process is rigorous andर transparent; candidates must pass science andर pharmacology exams andर engage in monitored andर assessed practical training in medical andर surgical dermatology. At the completion of the 5 year training programme, trainees sit a national written examination held over two days. Successful candidates may then proceed to the practical viva examination (held over 2 days) after which they may apply for fellowship status with the Australian College of Dermatologists.

To be a dermatologist in India, a minimum of 3 years of training is required after graduation from medical school andर [[medical intern|internship]]. The period involves rigorous training in all aspects of general dermatology, cosmetic dermatology, venereal diseases (including HIV) andर [[leprosy]]. At the end of the training period the resident has to go through written tests andर clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree clinical exams. The degree vvawarded is MD (dermatology, venereology andर leprosy). Most specialists also go for certification by the national board (for the award of 'diplomate of national board').

The skin is the largest [[organ (anatomy)|organ]] of the body andर obviously the most visible. Although many skin diseases are isolated, some are manifestations of internal disease. Hence, a dermatologist is schooled in aspects of [[surgery]], [[rheumatology]] (many rheumatic diseases can feature skin symptoms andर signs), immunology, [[neurology]] (the "neurocuteaneous syndromes", such as [[neurofibromatosis]] andर [[tuberous sclerosis]]), infectious diseases andर [[endocrinology]]. The study of genetics is also becoming increasingly important.

===Venereology andर Phlebology===

[[Venereology]], the subspecialty that diagnoses andर treats [[sexually transmitted disease]]s, andर [[phlebology]], the specialty that deals with problems of the superficial [[vein|venous system]], are both part of a dermatologist's expertise.

Cosmetic dermatology has long been an important part of the field, andर dermatologists have been the primary innovators in this area. In the 1900's dermatologists employed dermabrasion to improve acne scarring andर fat microtransfer was used to fill in cutaneous defects. More recently, dermatologists have been the driving force behind the development andर safe andर effective employment of lasers, new dermal filling agents ([[collagen]] andर [[hyaluronic acid]]), [[botulinum toxin]] ("Botox"), nonablative laser rejuvenation procedures, intense pulsed light systems, photodynamic therapy, andर [[chemical peel]]ing.

Dermatologic surgery (sometimes referred to as "Dermosurgery") is surgery performed by a dermatologipt physician. A [[Dermatologic Surgeon|dermatologic surgeon]] (sometimes known as a "Dermasurgeon") is a dermatologist with a special interest in this field who has applied for fellowship status in the [http://www.asds-net.org/ American Society for Dermatologic Surgery], a professional organization dedicated to supporting andर educating these physicians.

Techniques available to a dermatologic surgeon include lasers, traditional scalpel surgery, electrosurgery, cryosurgery, photodynamic therapy, liposuction, blepharoplasty (cosmetic eyelid surgery), minimally-invasive facelift surgery (e.g., the S-lift), andर a variety of topical andर injectable agents such as dermal fillers including fat transfer andर hyaluronic acid.

Any mole that is irregular in color or shape should be examined by a dermatologist to determine if it is a malignant [[melanoma]], the most serious andर life-threatening form of skin cancer. Following a visual examination andर a dermatoscopic exam (an invaluable new instrument that illuminates a mole without reflected light), a dermatologist may biopsy a suspicious mole. If it is malignant, it will be excised in the dermatologist's office.

The first step of any contact with a physician is the medical history. In order to classify a cutaneous eruption, the dermatologist will ask detailed questions on the duration andर temporal pattern of skin problems, itching or pain, relation to food intake, sunlight, over-the-counter creams andर clothing. When an underlying disease is suspected, an additional detailed history of related symptoms will be elicited (such as [[arthritis]] in a suspected case of [[lupus erythematosus]]).

Dermatology has the obvious benefit of having easy access to tissue for diagnosis. [[Physical examination]] is generally done under bright light andर preferably involves the whole body. At this stage, the doctor may apply [[Wood's light]], which may aid in diagnosing types of [[mycosis]] or demonstrate the extent of pigmented lesions, or use a [[dermatoscope]] which enlarges a suspected lesion andर visualizes it without reflected light. The dermatoscope is helpful in differentiating a benign [[naevus]] from [[melanoma]] or a seborrheic keratosis from a mole. A morphological classification of [[dermatological lesions]] is important in the diagnosis of dermatological disorders. Dermatologic diagnosis is often dependent upon pattern recognition of lesions andर symptoms.

[[Microbiological culture|Culture]] or [[Gram stain]]ing of suspected infectious lesions may identify a [[pathogen]] andर help direct therapy.

The skin is obviously accessible to topical local therapy. [[Antibiotic]] creams can help eliminate infections, while [[inflammation|inflammatory]] skin diseases (such as [[eczema]] andर [[psoriasis]]) often respond to [[steroid]] creams or topical anthralin. Dermatologists are innovators of new immune enhancing treatments, like topical imiquimod for superficial cancers andर injection immunotherapy for warts as discussed below.

Topical medications treat many dermatological diseases, but dermatologists also use oral [[medication]]s. [[Antibiotic]]s andर [[immune suppressant]]s or immune enhancing agents (injection immunotherapy or topical imiquimod) for dermatological diseases or tumors. Isotretinoin ("Accutane") is used for severe cystic acne vulgaris andर often produces a life-time remission of this disfiguring disease. Isotretinoin prescribing in the U.S. is now controlled by a cumbersome FDA governmental website called [[iPLEDGE]]. Various new modalities of treatment are in the foray, with the advent of laser technology things are quite promising.

From the basic science of cutaneous genetics andर immunology, to the practical application of new knowledge andर technology in the diagnosis andर management of skin disease (like [[psoriasis]]) andर surgical treatment of skin cancer, dermatologists have been among the leaders in the field. The annual meeting of the [http://www.aad.org/ American Academy of Dermatology] is one of the keys for rapid dissemination of new knowledge to the practicing dermatologist andर dermatologic surgeon.

* [http://dermatlas.med.jhmi.edu/derm/cd_lists.cfm Skin diseases andर disorders - dermatology atlas]

* [http://www.aslms.org/ American Society for Laser Medicine andर Surgery]

* [http://www.telederm.org/ The Community for Teledermatology] - telederm.org - Freely Available Online Teleconsultation andर Teledermatology Service in Dermatology