Important Issues in Dermatopathology

(The Field Specializing in Pathology in the Skin)

Dermatopathology is a subspecialty where practitioners should be Board Certified by both the American Boards of Pathology and Dermatology specifically in Dermatopathology.

Dermatopathology involves the interpretation of any piece of skin that has been removed from a patient. Dermatopathology renders the most accurate diagnoses available for patients who have problems with their skin, including unusual rashes and skin cancer. There is a great deal of variability in different doctor's ability to make accurate diagnoses of problematic skin cancers and rashes. There is even a great deal of variability between different centers around the country. A patient may receive a certain diagnosis from one well-known dermatopathologist only to receive an entirely different diagnosis from another. One would think that pathology would be open and shut, clearly one answer or the other, this is not the case around the country. There is on occasion a great deal of difference between one dermatopathologist and another. This is due to subjectivity, i.e. specific biases that each dermatopathologist might have from their training or experience in favor of one diagnosis or the other. This is all too common in Pathology and can lead to erroneous or mistaken diagnoses, which then can result in incorrect treatment. Patients not infrequently receive surgery that is unnecessary, or more importantly, do not receive surgery that is necessary leading to more serious medical problems down the road. This would also be true of certain rashes that go undiagnosed for long periods of time resulting in incorrect or delayed treatment and increased patient suffering.

Dr. Geisse is board certified in Dermatology and Dermatopathology. He is a practicing Dermatologist, Dermatologic Surgeon, Mohs Micrographic Surgeon and most importantly, Dermatopathologist. He did his residency and fellowships at the University of California San Francisco and is a Clinical Professor in the Departments of Dermatology and Pathology. He continues to teach Dermatology and Pathology residents at the University of California San Francisco in the field of Dermatopathology. The University of California San Francisco maintains preeminence in the field of Dermatopathology, unsurpassed by any in the country.

Because of Dr. Geisse's expertise in all three fields, i.e. Dermatopathology, Dermatology, and Dermatologic surgery, accurate diagnoses can be rendered, and at the same time, appropriate treatment plans can be delineated or outlined to help patients receive the best care possible.

Dr. Geisse reinterprets biopsies on patients performed elsewhere and interpreted by other pathologists on a daily basis, not infrequently resulting in a change in the patient's treatment plan. This usually involves reinterpretation of something that has been called malignant or "atypical" requiring further surgery to something banal that does not require further surgery. This spares patients unnecessary expense, pain, and scarring. Below are lists of actual cases that are just a sampling of the many situations where Dr. Geisse's interpretation has helped patients avoid unnecessary surgery, pain and suffering.