Who Should Examine Your Skin Biopsy?


The ultimate goal of a pathologist is to assist a clinician in the care of his or her patient. Critical to this endeavor is the correlation of clinical and pathological findings. Perhaps no area of pathology relies as heavily upon this correlation as does dermatopathology. Indeed, the specialty of skin pathology as we know it today is based in large part upon the contributions of great European dermatologists such as Unna, Hebra, Kaposi, Lever and Felix Pinkus (to name just a few), and that tradition was carried forth by great American dermatologists such as Hermann Pinkus, Clark and A.B. Ackerman. (1,2,3,4)

We at Aurora Diagnostics South Texas Dermatopathology Lab (ARDX STDL) strive on a daily basis to integrate clinical and pathologic aspects of skin disease in the tradition of those giants in our field in an effort to serve you in the care of your patients. As board certified dermatologists and dermatopathologists, we draw upon our clinical experience with every case in an effort to arrive at a specific diagnosis. In our pathology reports you will find a detailed microscopic description that will enable you to visualize what we are seeing under the microscope and an interpretation framed in the language of clinical dermatology, often with references, to guide you. We welcome clinical photographs and thoroughly enjoy discussing cases with our contributors so that we may share our clinical experience in patient management.

Training in cutaneous pathology for general pathologists is very variable, with many residency programs devoting little time to this complex area .(5) There are, of course, many fine pathologists who have completed fellowship training in dermatopathology, the best having maintained close associations with academic dermatology programs or completed an additional residency in dermatology. The vast majority, however, receive several months (at best) of clinical dermatology during their dermatopathology fellowship before beginning the daily sign-out of cases. As you well know, dermatology is a vast field encompassing disorders of the skin, hair and nails from birth to old age. Knowledge of inflammatory disorders, infectious disease, skin cancer, genetic disorders and skin signs of systemic disease are all required in the service of our patients. That is a daunting and humbling task, but also an enjoyable and academically stimulating one that we share with each other and our students on a daily basis.

So who should read your skin biopsies? We believe you and your patients will be best served by a clinically-trained dermatopathologist who can “see” what you are seeing and who can draw upon that clinical experience to achieve the best possible outcome. (6,7,8)