What podiatrists need to know about dermatopathologists

Q&A with two Bako Diagnostics dermatopathologists:

Kim Whisenant, M.D., and Carolina Montes, M.D. on partnering with podiatrists

Q. What is the importance of podiatrists being familiar with pathology, specifically dermatopathology?

A. Dr. Montes:
The skin is the largest organ of the body, and many medical specialties, including podiatry, come in contact with disorders of the skin. Lesions that appear on the skin, including the foot, can also be a manifestation of internal systemic disease. Consequently, it’s important for clinicians to be familiar with both inflammatory and neoplastic processes of the skin. Dermatopathology is the subspecialty of pathology that provides this knowledge.

A. Dr. Whisenant:
Because many dermatologic lesions – both benign and malignant – are commonly found on the lower extremities, podiatrists have a unique opportunity to evaluate patients and detect these lesions early on. The best way to detect these lesions is to be familiar with the dermatologic and pathologic presentation, and generate a clinical differential diagnosis, properly biopsy the lesion, and receive a more specific diagnosis.

Q. Your team has partnered with thousands of podiatrists to diagnose and treat the lower extremity. When should a podiatrist reach out to a dermatopathologist?

A. Dr. Whisenant:
If a lesion is biopsied incorrectly or sent in the wrong solution — or worse — in no solution, and allowed to air-dry, it can be difficult and sometimes impossible to diagnose. Podiatrists should work with a dermatopathologist when they have questions on specimen collection. The proper specimen collection and submission process is critical to getting to the right treatment.

A. Dr. Montes:
When reviewing Bako’s detailed report, podiatrists are encouraged to ask any questions pertaining to the diagnosis or recommended treatment. Our reporting dermatopathologists are easily accessible and eager to provide the best service.

Q. What should podiatrists consider when submitting a specimen to the lab for analysis and dermatopathologist reading and interpretation?

A. Dr. Whisenant:
When submitting a specimen, be sure the basic requisition forms are complete and add as much specific information as possible – biopsy site, lesion location/description/history, clinical differential diagnosis. In addition, uploading images of your patient’s lesion can be valuable to diagnosis and treatment suggestions. Upload capabilities are available for podiatrists through the Bako Diagnostics web portal.

A. Dr. Montes:
Understanding the appropriate scenarios to use the varying specimen collection techniques (punch, shave, scraping, excision, avulsion, etc.), the correct preservatives to use, and how to avoid sampling artifact – are all key to proper submission and diagnosis. Bako Diagnostics has published the “Lower Extremity Biopsy Techniques,” a Practice Essentials guide for the podiatric medical professional. This is helpful in identifying the best practices for specimen collection. A complimentary copy is available to all podiatrists at https://bit.ly/3sY6yks.