Changes in clinical practice within dermatology have led to a resurgence of dermatological surgery as a sub-specialty. The dermatologist’s skill-set not only includes the diagnosis and management of rashes but also increasingly the diagnosis and appropriate surgical management of both benign and malignant lesions. Skin cancer, particularly basal cell carcinoma, accounts for a large proportion of a dermatological surgeon’s caseload, with choice of treatment ranging from simple cryosurgery and curettage through surgical excision and Mohs micrographic surgery with challenging fascioplastic reconstruction. Although opinions regarding the relative efficacy of Mohs surgery vary, it has revolutionised the management of cutaneous malignancy in the USA and is influencing dermatology worldwide.
