Dermatologic surgery of the hand. General principles and avoiding complications

Dermatologists and dermatologic surgeons are frequently presented with significant pathology of the hand. Because the hand plays such a unique and important role in man's everyday life, preservation and restoration of its form and function is critical. The hand is both powerful and extremely delicate. Before performing any procedures in this area, dermatologists and dermatologic surgeons must have a clear understanding of the cutaneous and deep anatomy of the hand and digits, as well as a thorough knowledge of the disease process being treated and the modality being used. This article reviews the intricate anatomy, the proper hemostasis and anesthesia, and many of the complications seen in dermatologic surgery and procedures of the hand, digits, and nails. With appropriate preoperative evaluation and precautions, many dermatologic procedures may be safely performed on the hand.