Wells, AmyHarmel, AllisonSmith, Kristin N.Beers, PaulaQiu, YingjieDatta, SusmitaSchoch, Jennifer J.De Benedetto, AnnaLongo, IsabelMotaparthi, Kiran2024-05-302024-05-302022-08-29Wells A, Harmel A, Smith KN, et al. Impact of Skin Biopsy and Clinical-Pathologic Correlation in Dermatology Inpatient Consults. Cureus. 2022;14(8):e28534. Published 2022 Aug 29. doi:10.7759/cureus.28534https://hdl.handle.net/1805/41113Background: While studies of hospital dermatology have demonstrated diagnostic discordance between primary teams and dermatology consultants, little is known about the impact of biopsy and clinical-pathologic correlation (CPC) in consultation. This study compares biopsy performance based on diagnostic discordance and evaluates the impact of CPC on the diagnosis. Methods: This was a retrospective review of 376 dermatologic consultations at a single academic medical center between July 1, 2017, and June 27, 2018. Results: Biopsy was significantly less likely to be performed when the diagnosis by the referring primary team was unspecified (p < 0.001). In 24 percent of cases, the diagnosis based on histopathology alone differed from the diagnosis reached by formal CPC consensus review with either potential or significant impact on management. Conclusion: Dermatologists who perform inpatient consultations and rely on hospital-based pathology services may consider a consensus review for CPC. Requests to perform a biopsy may be interpreted as a request for diagnostic assistance rather than pressure to perform a procedure.en-USAttribution 4.0 InternationalDermatology consultationComplex medical dermatologyBiopsyConsult serviceInpatient dermatologyArticle