Clinicopathological correlation
Clinicopathological correlation is often the basis of accurate dermatopathological diagnosis. But who should perform this correlation? The dermatologist, the dermatopathologist or both? In my experience, in difficult cases, particularly when no clinical information is given, the pathologist often writes a descriptive report followed by the phrase “clinicopathological correlation is requiredâ€. This has major disadvantages. Firstly, no specimen should be sent to the laboratory without a full description of the lesion(s) and a clinical differential diagnosis. This will prevent for example a report of lichenoid keratosis being rendered in a patient with lichen planus which could save acute embarrassment at the next case conference. Secondly, a report should not be issued without a definitive diagnosis where possible. If it is left to the dermatologist to sort things out, the dermatopathologist will have an ever expanding collection of cases with no actual diagnoses. As an illustration, if a specimen is reported as a psoriasiform dermatosis consistent with plaque psoriasis, seborrheic dermatitis, psoriasiform drug reaction etc, then unless the pathologist contacts the dermatologist to obtain full clinical information and his/her opinion on the final diagnosis, the precise nature of the condition will remain a mystery to the pathologist. If then one wants to pull out all psoriasiform drug reactions, how can this be done? I would be interested to hear other’s thoughts on this problem.
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