What is a Dermatopathologist?

Dermatopathologists are physicians trained in both dermatology and surgical pathology, giving them the expertise to microscopically diagnose diseases of the skin.  One of the greatest challenges of dermatopathology is its massive scope: more than 1500 different disorders of the skin exist, including cutaneous eruptions (“rashes”) and neoplasms (“tumors”).  Dermatologists are able to recognize most skin diseases based on their appearances, anatomic distributions, and behavior.  Sometimes, however, those criteria do not allow a conclusive diagnosis to be made, and a skin biopsy is taken to be examined under the microscope.  This process, performed by a dermatopathologist, reveals the histology (microscopic anatomy) of the disease and results in a specific diagnostic interpretation.

What happens to my biopsy?

Most biopsies will undergo routine processing to be made into hematoxylin-and-eosin-stained glass slides which will be viewed by the dermatopathologist under the microscope in order to render a diagnosis.  Biopsy results should be expected within 2 weeks under normal circumstances.  Approximately 25% of cases, however, will require additional specialized testing and time to determine, for instance, the cell-type of origin of a tumor (squamous cell carcinoma, versus basal cell carcinoma, versus melanoma, etc.,  to highlight possible microorganisms (fungi, viruses, bacteria), and to determine whether or not a population of cells is malignant or benign.

This specialized testing may include using special stains, immunofluorescence, immunohistochemistry, flow cytometry, and molecular-pathologic analysis.  In the event of an unusual specimen, second and even third opinions may be obtained from other dermatopathologists and/or experts in order to ensure a correct diagnosis.  This process can sometimes be costly to both the provider of service and the patient, whose specimen is being evaluated. Be assured that we will keep your health and financial interests at the top of our priority list as we consider diagnostic tools and treatments for your condition.  If you have questions or concerns regarding your biopsy, please call 479-254-9662, Option 1. 

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