Dermatologic surgery in the office: specificities, current practices and perspectives

In France, medical practices are not legally defined, and there are no real equivalents to the “free-standing centers” or “office-based surgery” models found in Anglo-Saxon countries. Dermatologic surgery, although widely performed in private offices and recognized as an interventional procedure by the Haute Autorité de Santé, the National Cancer Institute, and the National Academy of Surgery, does not officially belong to surgical specialties. Dermatologists perform both diagnostic (biopsy, excision for histology) and curative procedures, most of which are single-stage surgeries due to adherence to clinical guidelines, given that most skin cancers are low grade. Since 2007, the HAS has considered the excision of superficial skin lesions safe, effective, and appropriate for outpatient practice under local anesthesia, or ambulatory care when needed. These interventions, consisting of simple excisions and repair techniques, have been shown to be safe, cost-effective, and independent of both the site of care and lesion type, provided that the environment, organization, and staff training are adequate. Ensuring patient safety, adherence to best practice standards, and institutional recognition of dermatologic surgery in medical offices remain key objectives.