Some wide cancer excisions, depending upon the location. I personally would like it if dermatologists could also do sentinel nodes and stuff, but I'm weird that way.
Derms can do something called a Mohs fellowship after residency. Mohs microsurgery a special technique used to assure clear skin cancer margins while taking the least amount of tissue possible. The problem is that not all dermatologists will be able to close complex Mohs excisions, and the pt will end up going to plastics for closure of the defect. I'd like to see dermatologists get more aggressive learning how to use various flaps for closure, etc.
Some dermatologists will do skin grafts.
Some derms take things up a notch and do lipo and blephs, etc.
Dermatologists also get to play with lasers, which is fun and rewarding.
I'm one of those crazy people who thinks the term "derm surgeon" doesn't have to be an oxymoron. I'm sure there'll be plenty of folks (esp. the plastics people) who will disagree vehemently.
I've seen some posts that claim derms can make well over a $1million/year. I thought this field was so competitive because of the hours and lifestyle. I didn't think they made much more than $250K/year. How can some of these derms make so much money? Do these minor surgical procesures really pay that much!
I personally know a dermatologist who has been known to clear a couple million a year. He makes more because (1) he does stuff like lipo and blephs, (2) he does lots of laser stuff, and (3) he has a health and beauty spa adjacent to his clinic. He, I think, is the exception rather than the rule.
And personally, I think it should stay that way. I've worked along side of dermatologists, and their idea of closing a biopsy frankly dismays me. The idea of these bozos doing anything more than shaves and punches is silly.
I can appreciate the training of the Mohs boys, but like you said, you dig your trench deep and long enough and pretty soon you've dug up the entire earth and need to call someone else to clean up after you. Not good business.
The dermatologists, plastic surgeons, and ENT's that are cosmetic surgeons who make the seven figure salaries usually have something on the side that generates that kind of revenue. you don't make that kind of money just personally doing the surgeries.... they often have "spas" or skin-care clinics which sell goods & some services as well as having multiple ancillary staff who do a large number of the things they make so much money from (the lasers, BOTOX injections, peels).