What You Need To Know About Your Body’s Largest Organ

Dermatology, the study of diseases of the skin—the human body’s largest organ–is both misunderstood and underrated. Even some physicians in other specialties think it’s “easy,” or borders on the trivial, but skin diseases are important because they are common, impose a huge economic and psychological burden on patients, and can be deadly.

In 2013, one American in four sought treatment for at least one skin ailment, and the average person was treated for 1.6 skin diseases. Nearly half of Americans over age 65 have skin disease, with an average of 2.2 each. Treatment of skin disorders accounted for $75 billion in medical, preventative and prescription and non-prescription drug costs.

Skin diseases are often serious, and many can actually be fatal. The threat of malignant melanoma is well-known, but non-melanoma skin cancer also causes or contributes to significant morbidity and mortality. Moreover, common skin diseases such as psoriasis are associated with serious medical conditions including heart disease and diabetes.

In spite of the importance and frequency of skin diseases, there are many myths and misconceptions about them and the dermatologists who diagnose and treat them. Things you should know:

  • Dermatologists don’t only do cosmetic procedures. They deal primarily with skin disorders, such as psoriasis, allergic and intrinsic eczema, lupus, acne and hair and nail disorders. They also diagnose skin cancer, and some specialize in the surgical removal of difficult skin cancers.
  • Many infectious and internal diseases have skin signs.
  • Dermatologists often make the initial diagnosis of sexually-transmitted diseases, which all have skin manifestations.
  • There are actually dermatologic emergencies, including sudden blistering of the skin; itching that disturbs sleep.
  • Many skin diseases have important implications for quality of life. Many patients with visible skin diseases often feel unattractive which can significantly decrease self-esteem and interfere with interpersonal relationships. There is a high rate of depression and anxiety in patients with many chronic skin disorders, including psoriasis, vitiligo, eczema and acne.
  • Melanoma, a potentially deadly form of skin cancer, is increasing at the fastest rate of all cancers in the United States. Many people believe that it develops only in sun-exposed areas, has to be raised, develops only in a mole, and occurs only in light skinned people and the elderly, but none of that is correct. Melanoma can completely fly under the radar unless you look for it.
  • There’s one potent risk factor for skin cancer that’s easy to avoid: According the CDC, exposure to ultraviolet (UV) rays while indoor tanning using a tanning bed, booth or sunlamp is known to cause cancers, including melanoma, basal cell carcinoma and squamous cell carcinoma. In addition, UV exposure also can cause cataracts and cancers of the eye (ocular melanoma).

Some people think the practice of dermatology is boring. In fact, sometimes you get to see wild and even macabre things:

  • A newly formed cyst on the scalp from which you pull out a couple of large botfly larvae (acquired in the rainforest in South America);
  • An elderly woman comes in with a rapidly enlarging “mole” on the back, which turns out to be a tick, engorged with blood;
  • A consultation request comes from the cardiology department to diagnose a rash in an elderly man. Upon closer examination, the rash is moving, and you find that it consists of live lice on his chest hair;
  • Old embedded objects, from glass shards to shrapnel, may work their way out through the skin years, or even decades, after they entered.

Thus, dermatology is far more than skin deep. So, if you see something, say something; an unexplained rash or skin lesion could be the sign of something significant.

Mullen, M.D., R. and Miller, M.D., H. (2017). Dermatology Is More Than Skin Deep: What You Need To Know About Your Body’s Largest Organ. [online] Forbes.com. Available at: https://www.forbes.com/sites/realspin/2017/04/19/dermatology-is-more-than-skin-deep-what-you-need-to-know-about-your-bodys-largest-organ/#245a9c685c7e [Accessed 7 Feb. 2019].

Renata H. Mullen practices dermatology in Palo Alto, California. Henry I. Miller, a physician and molecular biologist, is the Robert Wesson Fellow in Scientific Philosophy and Public Policy at Stanford University’s Hoover Institution.