Dermatopathology
Encyclopedia
Dermatopathology is a subspecialty of both dermatology
and surgical pathology
that focuses on the study of cutaneous diseases at a microscopic level. It also encompasses analyses of the potential causes of skin diseases at a cellular level. Dermatopathologists work in close association with dermatologists. In fact, some of them are trained primarily in dermatology themselves.
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
. That process reveals the histology
of the disease and results in a specific diagnostic interpretation. In some cases, additional specialized testing needs to be performed on biopsies, including immunofluorescence
, immunohistochemistry
, electron microscopy, flow cytometry
, and molecular-pathologic analysis.
One of the greatest challenges of dermatopathology is its scope. More than 1500 different disorders of the skin exist, including cutaneous eruptions ("rashes") and neoplasms. Therefore, dermatopathologists must maintain a broad base of knowledge, and be familiar with several other specialty areas in Medicine
.
Certification in dermatopathology in the United States requires the completion of a medical degree, followed by residency training of 3 years in dermatology or 4 years in anatomic pathology. Thereafter, an additional 1 or 2 years of post-residency education in dermatopathology is undertaken. For trainees with a primary background in Pathology, the fellowship experience includes the equivalent of 6 months of clinical dermatology, and for those whose training is primarily in Dermatology, 6 months of the fellowship are devoted to anatomic pathology. In the United States, dermatopathologists are first certified by the American Boards of Pathology
or Dermatology
, or the American Osteopathic Board of Pathology or Dermatology, and they then obtain subspecialty certification (termed "special competence") in dermatopathology by written examination. Since 2003, the International Board of Dermatopathology (IBDP)-- headquartered in Graz, Austria—also has certified candidates from countries around the world. This is done by IBDP review of applicants' professional qualifications, and a formal examination that is given in Europe each year.
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
and surgical pathology
Surgical pathology
Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by non-surgeons such as general internists, medical subspecialists,...
that focuses on the study of cutaneous diseases at a microscopic level. It also encompasses analyses of the potential causes of skin diseases at a cellular level. Dermatopathologists work in close association with dermatologists. In fact, some of them are trained primarily in dermatology themselves.
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
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
is taken to be examined under the microscope
Microscope
A microscope is an instrument used to see objects that are too small for the naked eye. The science of investigating small objects using such an instrument is called microscopy...
. That process reveals the histology
Histology
Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...
of the disease and results in a specific diagnostic interpretation. In some cases, additional specialized testing needs to be performed on biopsies, including immunofluorescence
Immunofluorescence
Immunofluorescence is a technique used for light microscopy with a fluorescence microscope and is used primarily on biological samples. This technique uses the specificity of antibodies to their antigen to target fluorescent dyes to specific biomolecule targets within a cell, and therefore allows...
, immunohistochemistry
Immunohistochemistry
Immunohistochemistry or IHC refers to the process of detecting antigens in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots "immuno," in reference to antibodies used in the procedure, and...
, electron microscopy, flow cytometry
Flow cytometry
Flow cytometry is a technique for counting and examining microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus. It allows simultaneous multiparametric analysis of the physical and/or chemical...
, and molecular-pathologic analysis.
One of the greatest challenges of dermatopathology is its scope. More than 1500 different disorders of the skin exist, including cutaneous eruptions ("rashes") and neoplasms. Therefore, dermatopathologists must maintain a broad base of knowledge, and be familiar with several other specialty areas in Medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
.
Certification in dermatopathology in the United States requires the completion of a medical degree, followed by residency training of 3 years in dermatology or 4 years in anatomic pathology. Thereafter, an additional 1 or 2 years of post-residency education in dermatopathology is undertaken. For trainees with a primary background in Pathology, the fellowship experience includes the equivalent of 6 months of clinical dermatology, and for those whose training is primarily in Dermatology, 6 months of the fellowship are devoted to anatomic pathology. In the United States, dermatopathologists are first certified by the American Boards of Pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
or Dermatology
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
, or the American Osteopathic Board of Pathology or Dermatology, and they then obtain subspecialty certification (termed "special competence") in dermatopathology by written examination. Since 2003, the International Board of Dermatopathology (IBDP)-- headquartered in Graz, Austria—also has certified candidates from countries around the world. This is done by IBDP review of applicants' professional qualifications, and a formal examination that is given in Europe each year.
See also
- List of skin diseases
- PathologyPathologyPathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
- Anatomical pathologyAnatomical pathologyAnatomical pathology or Anatomic pathology is a medical specialty that is concerned with the diagnosis of disease based on the gross, microscopic, chemical, immunologic and molecular examination of organs, tissues, and whole bodies...
- Surgical pathologySurgical pathologySurgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by non-surgeons such as general internists, medical subspecialists,...
- DermatologyDermatologyDermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
- Skin disease
- Skin lesion