Mai P. Hoang - Hospital-based Dermatopathology

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The recent Burden of Skin Diseases Report has cited that common skin diseases represented a healthcare cost in the United States of approximately 46 billion dollars in 2013 [1], being the majority managed by non-dermatologists. Therefore, it is not surprising that hospitalized patients with skin problems on non-dermatology inpatient services are a source of confusion for their hospitalists. Dermatologic consultations have a very large impact on the care of the hospitalized patients. In a 13-month retrospective chart review of 243 consecutive dermatology consultations by Connolly et al. [2], 77% were from the internal medicine, intensive care units, and hematology/oncology services. The common cutaneous conditions include infections (24%), drug eruption (22%), and inflammatory dermatoses (21%). These hospitalized patients often take multiple medications for comorbidities attributing to the frequent drug eruptions. Dermatology consultation resulted in altered or additional treatment in 72% of the cases [2]. When the authors analyzed the temporal relationship between the onset of the cutaneous disease and hospitalization, the skin condition was the reason for admission or coincided with admission in majority of cases [2].

Although common skin conditions account for a large majority of dermatologic consultations in a University Hospital setting, hospitalists continue to struggle with accurately recognizing and appropriately managing common skin problems. Very often, an urgent skin biopsy would be obtained by inpatient dermatology consult team, and its result will guide or change the clinical management in majority of cases. As inpatient dermatology consultation is promoted, the involvement of pathologists in turn will be increased. Awareness of these dermatologic conditions will result in accurate diagnosis, appropriate treatment, subsequently shortened hospitalization, and decreased cost. In this book, we aim to bridge this gap by providing a concise reference of the histologic and clinical findings of dermatologic conditions encountered in the inpatient setting. The text is divided into 20 chapters. Histopathologic images and corresponding clinical photographs facilitate clinical pathologic correlation of the conditions discussed in each chapter. Bulleted summary for quick easy-to-read reference and diagnostic pearls is provided for each of the discussed entities. Each chapter ends with several case studies in which clinical presentation, histologic interpretation, and work-up of these challenging scenarios are outlined.

This book represents an international collaboration and a wealth of clinical expertise and years of experience of authors from Africa, Asia, Europe, and North and South America. Many special thanks to all contributing authors for their exceptional efforts in making this book project possible. We greatly appreciate their generosity in sharing their fantastic cases and excellent pearls of wisdom.

Many thanks to the Springer team, including Senior Editor Richard Hruska, this books Developmental Editor Kevin Wright, Production Editor Sheik Mohideen, Project Manager Inicko Bharathi and the entire production team for their patience and invaluable help.

We sincerely hope that this book will serve as a useful go-to guide for the readers in rendering histologic diagnosis for hospital-based or inpatient skin biopsies. Ultimately, we hope that it will contribute to the excellent care of the patients.