Analysis of the Most Commonly Encountered Diagnoses in Academic Dermatopathology

Abstract

: The number of skin biopsies has increased over the last three decades, but benchmarks based on the number of biopsies required to capture skin cancers are lacking. To determine the most common dermatopathology diagnoses, reports of all 85,785 dermatopathology specimens examined in the Department of Dermatology at the University of Florida from January 2017 to December 2017 were reviewed. 78,353 non-excisional specimens were evaluated for diagnosis. 7,432 excisional specimens consisting of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma, and dysplastic nevi were evaluated for residual tumor and marginal status. The fifteen most common diagnoses accounted for 84% of all biopsies, and an additional 30 entities accounted for 12% of all biopsies. The remaining 4% of cases were composed of only 206 diagnoses. This pattern reflects current dermatology practice in the United States, wherein the 20 most commonly encountered diseases account for 85.4% of all diagnoses made by dermatologists. Among the total number of biopsies, 90.7% of specimens were neoplasms and 9.3% were inflammatory or infectious disorders. Uncommon (4%) and inflammatory or infectious (9.3%) disorders comprise a small minority of academic dermatopathology, with implications for resident and fellowship training.