Challenges of Dermatopathology practice in Sub Saharan Africa: Exploring Sustainable Solutions

Summary: The practice of dermatopathology in Sub Saharan Africa is beset with so many challenges. These challenges are related to the dearth of specialists as well as the inherent uniqueness of dermatopathology practice that present difficulty to the practicing anatomic pathologist. The lack of good interpretation obtained on mostly inflammatory skin biopsies has presented challenges to dermatologists in their clinical management of patients. As a result, so many dermatologists adopt the practice of treating patients using clinical diagnosis alone without recourse to undertaking a skin biopsy. This unwillingness of dermatologists to do skin biopsies has resulted in deleterious negative feedback that ultimately affects the competency of anatomic pathologist in terms of the specialty. The departments of pathology are all established in all the major tertiary hospitals in Nigeria. It is imperative to leverage on this relative advantage of having well established anatomic pathology system to bridge this wide disparity of providing dermatopathological services. The intervention that we have employed to address this disparity primarily involves bringing together local dermatologists and anatomic pathologists to be participating in signing out skin biopsies. This approach helps the local anatomic pathologist to apply the needed clinical dermatology context to interpreting challenging skin biopsies.