Some people feel it — an unceasing itch, swollen surfaces, or skin cancer. Others see it — the drooping jaw, the invasion of acne, or the ever–coming wrinkles. These symptoms and more often rush patients to see a dermatologist, aka the skin expert. An aging population and lifestyle choices are increasing the demand for dermatologists, according to a 2024 AMN Healthcare excerpt. One Lebanon newcomer jumped onto the frontlines to meet those needs in Wilson County, saying he wants to serve a population in need of board-certified dermatologists and specialized procedural services.
A medical dermatologist’s office traditionally focuses on pathologic skin conditions dealing with both benign growths, including warts, and various skin rashes. Diagnostic and minor procedures are then offered to treat these conditions. In Lebanon, Dr. Tej Mudigonda wanted to offer more.
“The big thing I wanted to do in my practice is offer a wide range of services under one umbrella,” said Mudigonda, the mastermind of the new Integrated Skin Institute standing on West Baddour right across from Vanderbilt Wilson County Hospital.
Whether the patient possesses a minor skin problem such as a skin growth or a larger concern such as a full-body rash or a skin cancer needing surgery, Mudigonda boasts the skills to bring about a solution.
The New Jersey native graduated from the University of Notre Dame before attending Vanderbilt University School of Medicine in Middle Tennessee and then Washington University of St. Louis to complete his dermatology residency training. He followed the training with a fellowship in the Bay Area at California Skin Institute. He excitedly returned to Middle Tennessee in 2024 to put these skills into practice.
Mudigonda aims to provide a comprehensive skin practice to address subspecializations in dermatology at Integrated Skin Institute. One area of specialization at the institute serves as the gold standard treatment for highrisk skin cancers — Mohs Micrographic Surgery, which involves surgically removing skin cancer layer by layer and locating healthy, cancer-free tissue, minimizing lost tissue, and maximizing the functional and cosmetic outcome.

“Oftentimes, some patients may want a quick fix — a cream, a minor surgical procedure, or superficial radiation treatments —- but these, unfortunately, do not quite get rid of the cancer completely and can lead to recurrences down the road,” Mudigonda said.
Mudigonda also renders a varicose vein clinic, providing medical and cosmetic treatments for lower leg veins. Treatments entail short, minimally invasive procedures, moving away from traditional, more invasive methods requiring surgical vein stripping.
The popular side of dermatology in the media rings to the name of cosmetic dermatology, keying on noninvasive approaches to augment patients’ beauty. These may involve skin care regimens
or more minimally invasive treatments, such as neuromodulators and Botox. Mudigonda’s practice offers this, but goes a step further. He developed what he describes as a state-of-the-art surgical center to execute aesthetic surgery procedures such as eye bag removal, face lifts, and liposuction. He believes cosmetic procedures are the best longterm answers.
The dermatologist retains excitement for his field’s future, sharing he sees artificial intelligence greatly supplementing — but not replacing — how conditions are diagnosed and new real-time imaging modalities assisting with real-time decisions in Mohs surgery, leading to more definitive and shorter procedures. He adds that professionals today are also better understanding specific pathways for certain dermatologic conditions — such as itches and hives — and witnessing new medications targeting specific mediators and pathways for traditionally difficult-to-treat conditions. In other words, the future shines bright for dermatology.

Throughout his career, the 37-yearold worked at hospitals with colleagues to assist him with the administration and management side of things. But possessing his own practice proved to be a whole different ball game with his current two medical assistant staff members — Nikki and Mandy — both bringing years of experience in dermatology and plastic surgery.
“The things I used to have and may have taken for granted has now fallen on my shoulders, but it is something I actually embrace because I feel I can do it well.”
The dermatologist would tell anyone that he is no superhuman. Just like any successful person, Mudigonda required assistance to achieve his goals. This came in many forms. But support came especially from his parents, who became “semi-employees” during the initial few months of starting his business. His dad served as the handyman, and his parents helped situated the rooms.
“As challenging as it was, I’m glad I had such supportive parents with complementary skills and saw the vision along with me.”
With their help, he opened the institute’s doors in August 2024 in a town he views as traditional, where everyone knows everyone in a growing and part medically-focused community — the perfect place to settle and start his business. GN