Closing the Diagnostic Divide: Defining Global Access to Dermatopathology - a Skinobservatory Study

Document Type

Conference Proceeding

Publication Date

7-1-2026

Publication Title

J Am Acad Dermatol

Keywords

Dermatology

Abstract

Introduction: Access to pathologic review by a trained dermatopathologist is an integral component of skin disease diagnosis management. [1,2] There is currently no worldwide assessment of access to dermatopathology. [3]. Methods: The Global Access to Skin Health Observatory (SkinObservatory) Study is a cross-sectional, Delphi-developed, survey of national-level dermatologic leaders in all 194 WHO member states. Participants reported number of dermatopathologists, presence of specialty board, training programs, and access to dermatopathology slide review. Responses were compared across World Bank Income (WBI) levels with Chi-squared and Kruskal-Wallis analyses. Results: Out of 157 countries responding, 139 reported on dermatopathology. Presence of dermatopathologists is associated with WBI level (p=0.024), with dermatopathologists present in 80% of high-income and 41% of low-income countries. Seventy-five percent of lower-income countries rank their access to dermatopathology as either “extremely poor” or “inadequate,” while 67% of higher-income countries report their access as “adequate” to “excellent.” Dermpatopathologist density is significantly associated with WBI (p=0.0001), with median dermatopathologists per 1,000,000 people of 0.0318 in low-income, 0.222 in lower-middle-income, 0.376 in upper-middle-income, and 2.45 in high-income countries. The presence of dermatopathology boards (p=0.026) and training programs (p=0.013) is more common in higher-income countries. Forty-seven countries have no dermatopathologists. In areas without dermatopathologists, dermatopathology is primarily done by: 1) general/surgical pathologists, 2) dermatologists, and 3) referrals to regional/national centers. Conclusion: Our data illustrates a global dearth of access to dermatopathology that disproportionately burdens lower-income countries. By providing a granular assessment of global access to dermatopathology, we aim to define avenues to improve access to this vital resource.

Volume

95

Issue

1

First Page

AB114

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