The staff of the Department of Dermatology sees approximately 30,000 patients per year. Given the size of our patient population, our residents encounter patients with a wide variety of cutaneous diseases and syndromes. Residents have the opportunity to work directly with members of the faculty on a one-on-one basis and run their own clinics under the supervision of voluntary attendings. In addition, they see consultations within the hospital. Because of the nature of the specialty clinic system at The Mount Sinai Medical Center, residents get significant experience not only in common skin diseases but also in rare conditions such as neurofibromatosis, cutaneous sarcoid, and other illnesses for which Mount Sinai's specialty clinics are famous.
The Department of Dermatology has a dynamic and expanding research program. Research in skin cancer has led to the identification of a substance that suppresses the development of chemical- and ultraviolet-induced skin cancers in animal models. Research is also underway on skin aging, resulting in the identification of molecular mechanisms that play a role in ultraviolet light-induced skin aging. Our research staff is studying 500 patients with pseudoxanthoma elasticum, a condition that is a model for accelerated aging characterized by prematurely aged skin, eye disease, and accelerated heart disease. An abnormal fetal protein responsible for the condition has been identified. In addition, a model in which adult fibroblasts can dedifferentiate to produce a fetal protein has been developed that may enable diagnosis of pseudoxanthoma elasticum.
Research on how cells organize themselves to form a specific organ is also being conducted. Using a skin equivalent, our scientists are studying the molecular events in the development of various layers of the skin, work that has implications for the development and treatment of burns and skin ulcers.
Our clinical trials in psoriasis have demonstrated that ultraviolet light can be blocked by many psoriasis treatments applied to the skin and in reverse, that some topical therapies are inactivated by ultraviolet light. Combinations of topical therapies that are incompatible have also been identified. Also under continuing study are an animal model of scleroderma, a new treatment for skin cancer, and new surgical devices likely to simplify dermatologic surgery.
Our Department runs one of the busiest phototherapy units in the world. We administer a wide array of treatments to patients with cutaneous conditions that respond to ultraviolet light treatment. Conditions treated include psoriasis, cutaneous T-cell lymphoma, atopic dermatitis, and various pruritic disorders. We see about 50 patients a day.
Cosmetic Surgery, Laser Surgery, and Mohs Micrographic Surgery
Our Department also has a Division of Dermatologic and Mohs Micrographic Surgery. Residents are given the opportunity to work with the director of this division to acquire surgical skills and knowledge about Mohs surgery and laser treatment. As part of the core curriculum, residents spend time working with the Mohs surgeon, assisting with various repairs and cosmetic procedures. Cosmetic procedures such as Botulinum toxin injection, various fillers for soft tissue augmentation, microdermabrasion, peels, sclerotherapy, skin grafts, hair transplantation, fat transfer, liposuction, various lasers for pigmented and vascular lesions in addition to nonablative photorejuvenation techniques are also performed by residents in our resident-run cosmetic clinic under direct faculty supervision.
Our residents have the opportunity to work individually and in groups with several experienced dermatopathologists. Opportunities for learning extend from direct observation to conducting independent research projects under the supervision of the head of the Division of Dermatopathology. A dermatopathology course is part of the core curriculum. Each week residents meet with the chief of the Dermatopathology Division to review textbook material and to go over the results of biopsies residents have performed in the clinic.