To the Editor:
Although traditionally taught at the microscope, dermatopathology has become ensconced in the digital space in recent years. Despite a planned gradual shift toward virtual microscopy, the COVID-19 pandemic expedited the implementation of virtual didactics to maintain resident education. A number of virtual dermatopathology resources now exist online, providing opportunities to learn dermatopathology from experts across the country. Shahriari et al1 explored this in their 2017 study; since then, the landscape has markedly expanded. We have compiled a comprehensive list of online dermatopathology resources that residents and fellows may utilize (Tables I and II).
Table I.
Free virtual slide libraries and digital unknown cases for dermatopathology education and training. Resources available as of October 2022
| Interactive virtual slide libraries | Access |
|---|---|
| American Society of Dermatopathology Virtual Academic Slide Sets (under “free educational resources”) https://www.asdp.org/about-asdp/covid-19-resources/ Fungal Infections Set https://sherwood-asdp.informz.net/informzdataservice/onlineversion/ind/bWFpbGluZ2luc3RhbmNlaWQ9OTIyNzg0NCZzdWJzY3JpYmVyaWQ9MTAxOTAxMDQxNw== |
Free |
| Atlas of Dermatopathology: https://atlases.muni.cz/en/index.html | Free (need account) |
| CDLS (Slide Study Set for residents): https://dermpathlab.com/residents/slide-study-set-program/ | Free (need account) |
| Juan Rosai's Collection of Surgical Pathology Seminars (Aperio): http://www.rosaicollection.org |
Free |
| University of Iowa Virtual Slidebox: https://medicine.uiowa.edu/it/web-design-services/virtual-microscopy-virtual-slidebox (redirects to https://www.mbfbioscience.com/iowavirtualslidebox for Biolucida software) | Free (need Biolucida software) |
| University of Leeds: http://www.virtualpathology.leeds.ac.uk | Free |
| University of Michigan Virtual Slide Box https://www.pathology.med.umich.edu/slides/index.php |
Free |
| PathPresenter (Virtual slides, multiple dermpath channels) https://pathpresenter.net |
Free (need account) |
| Static virtual slides | |
| Dermatopathology Interactive Atlas: http://www.dermpathatlas.com | Free (need account) |
| Dermatopathology Institute Slide Atlas: http://www.dermpathmd.com/dermatopathology_slide_atlas.htm | Free |
| University of Basel (Pathorama): http://pathorama.ch | Free |
| WebPathology: http://www.webpathology.com | Free |
| Interactive/unknown cases | |
| American Society of Dermatopathology (interactive Case Study of the month, Case Study Archives) https://www.asdp.org/education/case-study-of-the-month/case-archive/ |
Free |
| Pathology Outlines: http://www.pathologyoutlines.com | Free |
| DermOID Online Interactive Dermatopathology UCLA: https://derm-oid.ctrl.ucla.edu | Free (need account) |
| RecutClub: https://www.recutclub.com | Free (need account) |
Table II.
Online lecture and social media resources for dermatopathology education and training. Resources available as of October 2022
The full methodology is outlined in the Supplementary material (available via Mendeley at https://data.mendeley.com/datasets/xpxh9h2ydp/1). In short, we used Shahriari et al’s1 study that highlighted dermatopathology education with a subsection listing online dermatopathology resources. In addition to these resources, we utilized Youtube, Facebook, and Twitter by searching “dermatopathology.” We also polled expert dermatopathologists with an interest in developing online education content (authors of this study) to find any additional resources. Any additional resources identified by this group were added to the list.
Digital dermatopathology has advanced over the years because of a number of factors. Perhaps most pertinent is the development of whole-slide imaging, a modality that allows for high resolution capture of histologic sections, image storage in digital libraries, and subsequent transmission to mobile devices or computer screens. In addition, improvements in mass electronic media (eg, social media: Youtube, KiKo, etc.) and telecommunication (eg, video-conferencing: Zoom) have rendered digital dermatopathology highly accessible.
The technology has become so pervasive that the modality has been integrated into board examinations, such as the dermatopathology portion of the American Board of Dermatology’s CORE Examination and the entirety of the Dermatopathology board examination.2 Residents have shown at least no preference in which modality to use, and sometimes actually prefer virtual microscopy.3
The concurrent use of virtual microscopy with electronic media allows for the live or recorded delivery of dermatopathology. This allows learners from all over the world, including those from low-resource settings or with limited dermatopathologist expertise to engage in a structured curriculum. Although virtual dermatopathology has great potential in both the clinical and educational realms across the globe, it is limited, in particular, by a significant cost in implementation in addition to the ever-changing palette of online content.4 Additionally, it may lead to neglect of light microscopy technical skills, requires fast and stable internet connection, and needs large amounts of computer memory for storage. Notably, certain histologic features may have variable appearances when noted on virtual versus light microscopy. Light microscopy also fairs better than virtual microscopy in certain functions, such as identifying gram-positive bacteria.5 Other considerations, such as maintenance of patient anonymity and compliance with both state and federal mandates fall to the content creator.4 Despite this, the use of virtual dermatopathology for individual consumers/learners can be free in many cases. Empowering dermatopathologists and pathologists in the endeavor to enhance and refine these materials over time may result in long-lasting improvements in education, dermatopathology access, and collaborative patient care.
Conflict of interest
None disclosed.
Footnotes
All the included resources developed by any author that is on this paper are available free of charge and the authors do not receive any direct compensation for their work.
Funding sources: None.
IRB approval status: Exempt.
References
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