What Is a Dermatopathologist?

Dermatopathology is a subspecialty of dermatology that focuses on identifying skin diseases by examining samples under a microscope. Dermatopathologists work with dermatologists and pathologists to help diagnose skin diseases.

This article reviews what type of skin diseases dermatopathologists investigate, as well as techniques and training.

Concentrations  

The main focus of a dermatopathologist is to aid in diagnosing skin diseases. Unlike dermatologists, who work directly with patients to examine and treat skin diseases, dermatopathologists are tasked with examining samples or biopsies of a person’s skin underneath a microscope to help determine what is happening on a cellular level.

While their job is different from that of a dermatologist, the two professions are linked. While the dermatologist works with patients, collects samples, and formulates a treatment plan, the dermatopathologist is designed to help with the diagnostic process. The two work together to help serve people with various skin conditions.

Dermatopathologists do not treat skin conditions, though they can identify the microscopic patterns of various skin conditions, such as:

• Eczema
• Psoriasis
• Lichen planus
• Bullous pemphigoid
• Vasculitis
• Granuloma annulare

Techniques

There are certain examination techniques used by dermatopathologists to help them identify abnormalities in skin samples. Techniques can include:

• Stains: Stains use dyes and chemicals on sections of skin to help highlight and identify any cellular abnormalities or substances that could indicate disease.
• Frozen sections: Frozen sections are rarely used, however, they can be in instances in which a dermatologist needs to make a quick diagnosis during surgery. The skin sample is frozen and then examined under a microscope right away using a stain.
• Immunohistochemistry: By using the body’s antibodies, this technique identifies locations of specific antigens, which are molecules that alert the immune system to react. Then a stain is used to see the interaction between both the antigens and antibodies.
• Direct immunofluorescence: This is a type of staining that is designed to identify specific autoimmune skin diseases, which are diseases that occur when the immune system mistakes healthy skin cells for foreign invaders and begins attacking them. 

How Are Dermatopathologists Trained?

Dermatopathologists have the degree of either doctor of medicine (MD) or doctor of osteopathy (DO).

To obtain an MD degree, they have to complete an undergraduate four-year college program and take premedical courses to be able to apply to medical school upon graduation. Passing the Medical College Admission Test (MCAT) is also a requirement to be accepted into medical school.

Medical school is split up into two categories, which are:

• In-class learning is done for the first two years of medical school.
• Clinical learning is a type of hands-on learning that is done within hospitals. This occurs during the second two years of medical school.

After graduating from medical school, a person is awarded their degree as a doctor of medicine.

New doctors must also obtain a license to practice medicine in their state, as well as complete a residency program of their choosing. A person looking to become a dermatopathologist has two routes they can take during their residency: practice dermatology or practice pathology.

To become a dermatopathologist, you must have certification with either the American Board of Dermatology as a dermatologist or the American Board of Pathology as a pathologist prior to taking a one-year training course specializing in dermatopathology.  

After all schooling and training is complete, those looking to become dermatopathologists must complete a final exam.

Summary

Dermatopathology is a subspecialty of dermatology and pathology. Dermatopathologists aid in the diagnostic process for skin conditions by examining skin tissue cells to look for abnormalities and see if there are any signs of disease.

While they do not treat diseases, dermatopathologists are vital to the diagnosis process. Because of this, they require the same level of schooling and training as other doctors. That said, they also have to take an extra year of specialized training to be able to work in the highly specialized area of dermatopathology.

A Word From Verywell

A career in dermatopathology requires a lot of dedication and a significant time commitment, but it is an admirable and interesting career path. If you do decide to take this route, you can help dermatologists diagnose various skin diseases. Since many skin diseases, including skin cancer, can be fatal, becoming a dermatopathologist means you could make a positive change in people's lives.