Pigmented Lesions

Inflammatory Dermatoses

Skin Neoplasms

Dermatopathology Diagnostic Accuracy
and Concordance

Mnemonics for Dermatology/Dermatopathology



Dermatopathology is pattern recognition. From that perspective, a dermatologist is uniquely qualified to excel in this specialty. The key is to adapt the same skill sets that enable you to recognize clinical disease patterns and apply it to the microscope slide. It may take some of you more time to master the basic skills of reviewing a dermatopathology slide, but don't worry, you will all reach this goal!

The secret to learning dermatopathology is to view microscopic slides with a clinical eye and to view clinical lesions with a microscopic eye.

Play to your strengths and use your clinical skills! For example, if the lesion is an infiltrative and indurated plaque on the face of an adult woman, your clinical differential diagnosis would include granuloma annulare, sarcoidosis, granuloma faciale, an adenxal tumor, and a lymphoma. With that clinical information as your background, look at the slide and ask yourself whether the histopathology matches any of your leading clinical impressions. You may easily eliminate these broad categories of disease and narrow your differential diagnosis. The converse is to view a microscope slide and extrapolate what the lesion may have looked like on the patient. Is this a young patient, an old patient? Is it acral skin or a mucosal surface? Is it an acute or chronic process? You may not recognize all of the histopathologic patterns you are viewing but by discerning where the lesion is arising and what the clinical apperance is, you can again utilize your clinical skills and arrive at a reasonable differential diagnosis.

Start with the Primer of Dermatopathology presentations which provide a broad introduction to dermatopathology. Once you are comfortable, move on to the differential diagnostic patterns. These provide a broad framework to categorize dermatopathology lesions and help to quickly generate a differential diagnosis based only upon the histopathologic pattern. Challenge yourselves with the weekly unknown slides and always have a good dermatopathology textbook at your side.

Finally...enjoy! Dermatopathology completes your dermatology education and may encourage some of you to rethink core principles of dermatologic diseases. It is my earnest desire for all of you to experience the same elation that I have when a new and fascinating chapter in dermatology is unvieled as a novel observation is rendered for the first time from the microscope slide.

These presentations are stored as Adobe PDF files and you will need a reader to access these.

A Primer of Dermatopathology We've Only Just Begun!

The following presentations are intended as an overall review and introduction to Dermatopathology.

Dermatopathology: We've Only Just Begun! General Approach to Histopathology

Dermatopathology: We've Only Just Begun! Basic Histopathological Patterns

Dermatopathology: We've Only Just Begun! Inflammatory Algorithms

Dermatopathology: We've Only Just Begun!
The Quest for the Ultimate Special Stain-Revealed!

Dermatopathology: Margins of Resection for Skin Cancers

Immunofluorescence of the Skin

Primer of Immunohistochemistry-
(Spindle Cell Tumors)

Primer of Immunohistochemistry-
(Epithelial Tumors)

Primer of Immunohistochemistry-
(Leukocytic Tumors)

Primer of Immunohistochemistry-
(Pleomorphic Tumors)

 Instant Pattern Recognition

Dermatopathology Differential Diagnoses

Titles that are marked with an asterisk (*) are part of the "must know" patterns for dermatology boards.

Actinic Keratosis versus Bowen's Disease
Band-like Upper Dermal Infiltrate
Basal Cell Carcinoma versus Bowen's Disease
Blue nevus versus Tattoo
Blue Tumor
Blue Infiltrate
Bowen's Disease versus Seborrheic Keratosis
Boxcar (Square biopsy) Sign*
Cell poor subepidermal bulla*
Cell rich subepidermal bulla*
Central Pore
Change in Fat
Circular Dermal Islands
Clear Cells in Dermis
Combined Nevus versus Nevus with Tattoo
Clear Cells in Epidermis*
Collagenoma versus Leiomyoma
Cords and Tubules
Corp ronds*
Deep tissue biopsy with no epidermis*
Dermal Material
Dermatofibroma versus Combined Nevus
Eosinophils on face*
Eosinophilic spongiosis*
Epidermal necrosis
Fascicles and Bundles*
Giant Cells
Granuloma Annulare versus Necrobiosis Lipoidica
Grenz zone*
Interface Reaction
Melanocytic Cells
Minimal Changes (Invisible Dermatoses)*
Monotonous cells*
Mucin and Glands or Ducts
Palisading Reactions
Papillated Dermal Tumor
Perineural Inflammation
Perivascular Infiltrate
Pink Dermis
Pink Material
Plugged Vessels*
Polypoid Lesions on Acral Skin*
Poroma versus Seborrheic Keratosis
Proliferation Downwad from Epidermis
Pseudoepitheliomatous Hyperplasia Above Abscesses
Regular Acanthosis
Sarcoidal Granulomas*
Space With a Lining
Spindle Cells
Spiradenoma versus Nodular Basal Cell Carcinoma
Spiradenoma versus Nodular Basal Cell Carcinoma-2
Suppurative Granuloma versus Biopsy Site Scar and Foreign Body Granuloma
Subepidermal Space/Cleft
Suggestion of Vessels
Superficial and Deep Lymphocytes*
Upper Dermal Edema*
Upper Epidermal Changes




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