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Dermatopathology is a subspecialty of anatomical pathology devoted to the study of benign and malignant diseases of the skin. Dermatopathologists work in close association with dermatologists.

Dermatologists recognize most skin diseases based on their appearance, distribution on the body and behaviour with time. Occasionally, these criteria are not enough and a skin biopsy is taken to be examined under the microscope. This microscopic examination reveals the histology of the disease and clarifies the diagnosis.

One of the greatest challenges of dermatopathology is the high number of different skin diseases. There are an estimated 1500 different rashes and skin tumors. Therefore, dermatology and dermatopathology are among the most complex specialties of Medicine.

Dermatopathologists are physicians who after completing their training in either dermatology or pathology pursued additional training in accredited programs for the interpretation of skin biopsies. These physicians integrate the clinical information with microscopic observations of the biopsy from the patient to provide diagnostic information to the treating physician. Dermatopathology is a consultative service to the referring dermatologist and not simply a laboratory test. Your dermatopathologist is an important member of your health care team. The accurate microscopic interpretation of the biopsy is important in understanding your diagnosis and the selection of appropriate treatment.

What is dermatopathology?

Dermatopathology, a subspecialty of pathology, is the study and description of changes that occur in the skin as the result of disease. The practice of dermatopathology involves the microscopic examination, description and interpretation of specimens by a trained dermatopathologist.

What is a dermatopathologist?

A dermatopathologist is a physician who has completed training in dermatology and/or anatomic pathology and has completed additional training for the interpretation of skin specimens in an accredited dermatopathology program. These physicians integrate the clinical information provided by the referring dermatologist with microscopic observations of the skin biopsy to arrive at a specific finding or diagnosis.

How are skin biopsies examined?

Skin biopsies are processed into microscopic slides and then stained with Hematoxylin and Eosin (H&E), a routine histology stain. Using this stain, structures of the skin with an affinity for the basic dye Hematoxylin stain blue-purple, while structures with an affinity for the acidic dye Eosin stain bright pink. This allows the dermatopathologist to visualize the cellular detail of the biopsy and to distinguish between constituent parts of cells and intracellular material. The dermatopathologist can then systematically examine the biopsy by looking at the structure of the epidermis, dermis, subcutis, fascia and underlying structures at a microscopic level. Based on the findings, the dermatopathologist may come up with a definitive diagnosis, or list several possible explanations, creating a differential diagnosis. The integration of clinical information in conjunction with the pathological findings generates the final diagnosis.

Additional special stains and immunostains may be requested to help identify microorganisms (e.g. bacteria or fungi), specific substances deposited in the skin (e.g. melanin or amyloid) or specific markers to identify the origin, nature and distribution of cells in the specimen being examined.

How long does it take to receive test results?

Depending on the test performed, most tests are completed and reported to your ordering healthcare provider within 24-48 hours of receiving the specimen. Certain tests may take longer. Results are sent directly to the ordering healthcare professional. Your healthcare provider will contact you when your pathology report has been received.

Basal Cell Carcinoma
Melanoma
Squamous Cell Carcinoma

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