Dermatopathologists

Dermatopathologists are physicians who diagnose skin diseases by examining tissue under the microscope. They operate at the intersection of dermatology and pathology, interpreting skin biopsies and surgical specimens to classify inflammatory, infectious, autoimmune, and neoplastic conditions, including malignant melanoma and other skin cancers, as well as less common cutaneous disorders.

Training typically includes medical school followed by a residency in pathology and a dermatopathology fellowship; some physicians pursue dermatology residency with a dermatopathology fellowship. Certification as a dermatopathologist is offered as a subspecialty by the American Board of Pathology, with some dermatology-trained physicians obtaining subspecialty certification through the American Board of Dermatology.

In practice, dermatopathologists use histology, special stains, immunohistochemistry, and molecular testing to refine diagnoses. They analyze punch, shave, and excisional biopsies, sign out pathology reports, and may provide second opinions. They also participate in frozen-section consultations during procedures, including Mohs surgery contexts, to aid intraoperative decision-making.

Most dermatopathologists do not regularly see patients in clinic; their work centers on tissue interpretation and collaboration with clinicians. They are employed in hospital and academic laboratories, private reference labs, and increasingly in integrated health systems. Their findings influence treatment choices, prognosis, and surveillance, and they contribute to education and research in cutaneous diseases.