In this issue, we hope to explore the history of dermatologic
surgery and also delve into new discoveries in the field. In
the 1930s, Frederick Mohs introduced chemosurgery to
dermatology and expanded the way in which dermatologists
treated skin cancers. Although Mohs micrographic
surgery has become an indispensable treatment modality
for skin cancer, enhancements have been made in the
medical management of advanced skin cancers. Dermatologists
have further expanded their skill set in surgery to
encompass cosmetic surgery with injectables, peels, laser
surgery, tumescent liposuction, hair transplant surgery,
and beyond. Many of the advancements in dermatologic
surgery have come within the past decade. We have seen
the emergence of fractionated laser technology and a burgeoning
field of noninvasive body contouring, which has
revolutionized our ability to offer nonsurgical options to our
patients. We have also witnessed clever applications of old
technologies and materials to treat difficult, recalcitrant conditions.
As the field continues to grow, dermatologic surgeons
are expanding their skill set, and the horizon looks
bright for dermatologic surgery. We have sought to compile
an exciting array of articles from thought leaders in the field
that highlight the past, present, and future of dermatologic
surgery.
Bill Hanke opens the issue reviewing key moments in the
history of dermatologic surgery. Next, Kelley Redbord and
Bill were able to assemble a unique well-illustrated biography
of the late Samuel Stegman. Bill has access to all of Dr Stegman’s
papers, and thus, he was able to compile a fascinating
article on one of the specialties’ pioneering dermatologic surgeons.
The past and future of soft tissue fillers is then reviewed
by Rick Glogau. Doru Alexandrescu and Vic Ross
follow with a discussion of the manifold current and future
uses of lasers in cutaneous medicine and surgery. Cutaneous
vascular lesions have long been treated with lasers and light
sources but complete removal of many vascular lesions and
malformations remains a difficult task. The future for the
treatment of such lesions is reviewed by Kristen Kelly and
colleagues. The use of fractionation in delivery of laser energy
has brought about rapid and dramatic conceptual and practical
changes in how we can deliver care, and Nazanin Saedi
and colleagues review fractional laser use in the treatment of
esthetic and medical disorders. One of the most exciting observations
in recent years has been the dramatic effectiveness
of ablative fractional resurfacing in the treatment of traumatic
scars and contractures in wounded warriors. These studies
have been carried out at the Naval Medical Center in San
Diego and are described by Nathan Uebelhoer, Vic Ross, and
Peter Shumaker.
Body contouring and sculpting is one of the great areas of
most intense current interest in esthetic medicine and dermatology.
Noninvasive fat removal, an important aspect of
this field, is discussed by Ray Jalian and Matthew Avram.
Arielle Kauvar treats us to a discussion of a new approach to
the treatment of melasma using low-fluence Q-switched neodymium-
doped yttrium aluminium garnet lasers to target
melanosomes. Low-level laser therapy has long been used
with some success in Asia and other parts of the world and is
now finding broad application for a variety of pigmented and
textural problems. The treatment of hyperpigmentation in
skin of color is very challenging, and this topic is nicely
reviewed in-depth by Sailesh Konda, Aanand Geria, and Rebat
Halder. Lastly, there is a short discussion of the cutting
edge in cutaneous oncology treatments by Kim Chong and
colleagues.
We sincerely hope that you find this issue informative and
enlightening.