title: Influence of evaluation of clinical pictures on the histopathologic diagnosis of inflammatory skin disorders.
abstract: BACKGROUND
  Clinical information on histologic referral sheets is usually very limited, and particularly for inflammatory skin disorders, dermatopathologists often ask referring physicians for clinical correlation.
  
  
  OBJECTIVE
  In this study we tested the value of clinicopathologic correlation in the histopathologic diagnosis of inflammatory skin disorders.
  
  
  METHODS
  One-hundred biopsy specimens were digitalized and stored on 3 DVDs along with the clinical images. All cases were evaluated by 9 independent full-time dermatopathologists, initially without looking at the clinical pictures and subsequently after checking them. All diagnoses were finally compared with the "reference" diagnosis established in Graz, Austria, and the results were statistically analyzed.
  
  
  RESULTS
  After evaluation of the clinical images, the number of dermatopathologists making a correct diagnosis was increased in 70 cases, unchanged in 25 cases, and decreased in 5 cases. The total number of correct diagnoses increased from 332 (diagnoses before evaluation of clinical pictures) to 481 (diagnoses after evaluation of clinical pictures), with a 16.6% increase in the total.
  
  
  CONCLUSIONS
  The computerized setting is different from real-life dermatopathology and physical examination of patients.
  
  
  CONCLUSIONS
  Our study clearly shows that clinical pictures should be added to biopsy request slips of inflammatory skin disorders whenever possible, as they allow a better interpretation of histopathologic findings.
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria. lorenzo.cerroni@medunigraz.at
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Argenyi
authors.forename: Rino
authors.initials: R
authors.lastname: Cerio
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchetti
authors.forename: Harald
authors.initials: H
authors.lastname: Kittler
authors.forename: Heinz
authors.initials: H
authors.lastname: Kutzner
authors.forename: Luis
authors.initials: L
authors.lastname: Requena
authors.forename: Omar P
authors.initials: OP
authors.lastname: Sangueza
authors.forename: Bruce
authors.initials: B
authors.lastname: Smoller
authors.forename: Janine
authors.initials: J
authors.lastname: Wechsler
authors.forename: Helmut
authors.initials: H
authors.lastname: Kerl
mesh_terms: D001317:Austria; D001707:Biopsy, Needle; D015331:Cohort Studies; D016001:Confidence Intervals; D003872:Dermatitis / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D003880:Dermatology / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D012042:Registries; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000175:diagnosis / Q000473:pathology