Cerroni et al.: Influence of evaluation of clinical pictures on the histopathologic diagnosis of inflammatory skin disorders

Cerroni, L; Argenyi, Z; Cerio, R; Facchetti, F; Kittler, H; Kutzner, H; Requena, L; Sangueza, OP; Smoller, B; Wechsler, J; Kerl, H.
Influence of evaluation of clinical pictures on the histopathologic diagnosis of inflammatory skin disorders.
J Am Acad Dermatol. 2010; 63(4):647-652 PubMed FullText FullText_MUG

Abstract:
BACKGROUND: Clinical information on histologic referral sheets is usually very limited, and particularly for inflammatory skin disorders, dermatopathologists often ask referring physicians for clinical correlation. OBJECTIVE: In this study we tested the value of clinicopathologic correlation in the histopathologic diagnosis of inflammatory skin disorders. METHODS: One-hundred biopsy specimens were digitalized and stored on 3 DVDs along with the clinical images. All cases were evaluated by 9 independent full-time dermatopathologists, initially without looking at the clinical pictures and subsequently after checking them. All diagnoses were finally compared with the "reference" diagnosis established in Graz, Austria, and the results were statistically analyzed. RESULTS: After evaluation of the clinical images, the number of dermatopathologists making a correct diagnosis was increased in 70 cases, unchanged in 25 cases, and decreased in 5 cases. The total number of correct diagnoses increased from 332 (diagnoses before evaluation of clinical pictures) to 481 (diagnoses after evaluation of clinical pictures), with a 16.6% increase in the total. LIMITATIONS: The computerized setting is different from real-life dermatopathology and physical examination of patients. CONCLUSION: Our study clearly shows that clinical pictures should be added to biopsy request slips of inflammatory skin disorders whenever possible, as they allow a better interpretation of histopathologic findings.


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