Interpretation of Cutaneous Biopsy Specimens
Background. Primary care providers (PCPs) have limited training in recognizing common skin disorders, and additional emphasis may be placed on laboratory evaluation, including skin biopsies.
Methods. Primary care providers in Miami, Fla, were surveyed regarding skin biopsy and excision practices and histologic interpretation. They then participated in an examination, using 20 high-quality color photographs of common dermatologic disorders.
Results. Of the 80 PCPs who participated, 42% currently do skin biopsies and consult general pathologists for interpretation. Another 20% of PCPs intend to do biopsies within the next 5 years. Only 33% prefer to have a dermatopathologist interpret histopathology. We found no correlation between PCPs' scores on diagnostic testing and whether they do skin biopsies.
Conclusion. Nearly all PCPs doing skin biopsies in our study sample use general pathologists to interpret histopathology. The limited training in clinical dermatology of both PCPs and general pathologists may result in compromised clinical-pathologic correlation.
Primary care providers (PCPs) see and treat the majority of patients with skin disease. Lack of clinical training in dermatology likely has led to decreased diagnostic proficiency. In an effort to curb the cost of specialty care, systems of health care delivery have been developed that require patients to see their PCPs first for skin disease. This may result in expanded utilization of diagnostic testing, including skin biopsies.
With regard to the skin biopsies, two questions arise. The first is whether PCPs do biopsies within the context of their practice. Second, whom do they use to interpret histopathology specimens?
Background. Primary care providers (PCPs) have limited training in recognizing common skin disorders, and additional emphasis may be placed on laboratory evaluation, including skin biopsies.
Methods. Primary care providers in Miami, Fla, were surveyed regarding skin biopsy and excision practices and histologic interpretation. They then participated in an examination, using 20 high-quality color photographs of common dermatologic disorders.
Results. Of the 80 PCPs who participated, 42% currently do skin biopsies and consult general pathologists for interpretation. Another 20% of PCPs intend to do biopsies within the next 5 years. Only 33% prefer to have a dermatopathologist interpret histopathology. We found no correlation between PCPs' scores on diagnostic testing and whether they do skin biopsies.
Conclusion. Nearly all PCPs doing skin biopsies in our study sample use general pathologists to interpret histopathology. The limited training in clinical dermatology of both PCPs and general pathologists may result in compromised clinical-pathologic correlation.
Primary care providers (PCPs) see and treat the majority of patients with skin disease. Lack of clinical training in dermatology likely has led to decreased diagnostic proficiency. In an effort to curb the cost of specialty care, systems of health care delivery have been developed that require patients to see their PCPs first for skin disease. This may result in expanded utilization of diagnostic testing, including skin biopsies.
With regard to the skin biopsies, two questions arise. The first is whether PCPs do biopsies within the context of their practice. Second, whom do they use to interpret histopathology specimens?