ABSTRACT
When discussing the subject of dermatopathology with a second year resident, he said, “It’s like a brick wall that you keep hitting-over and over again”. Eventually you break through that initial barrier and get a grasp of the material, but it might not even be until the second year of residency until you begin to do so. It would be difficult to try and memorize 2,000 histopathological findings for different skin diseases by categorizing them in your mind as distinct, separate entities. Using the pathologic basis provides one way to categorize the diseases, but this approach does not lend itself to converting histological characteristics to the diagnosis. Nevertheless, this was the standard approach to dermatopathology not long ago. Instead, an ordered, structured approach based on histology characteristics presents an ideal means of organizing our understanding of dermatopathology and more easily coming to a diagnosis based on the histological findings. Once the basic structure of this organizational scheme is understood-something that can be quickly grasped by new residents in dermatology and pathology-more detailed, complex and rarer conditions can be understood within a greater hierarchy of subjects. Thus, one begins with the understanding of the skeletal structure, then adding on more flesh as one delves deeper into dermatopathology. The intent of this book is to introduce the new resident to dermatopathology in an easily approachable format that can be reviewed in the first month (ideally the first few days) of their training. This guide is a general overview to be used to refresh the learner on general principles of histopathology and to establish an outline of the subject. Each topic is illustrated within a flow chart showing similar diseases by histology and where it lies in the greater scheme of dermatopathology. In this format, we hope for residents to be less intimidated by the vastness and intricacies of the subject. We present a basic design that can be easily added to as residents learn the subject in greater detail throughout their training. Perhaps in this way dermatopathology will not resemble such a ‘brick wall’ and can be understood much earlier to help complement the rest of their dermatology studies.
