Inflammatory Dermatoses: An Audit of Histopathology Reporting Quality and the Role of Clinicopathological Conference

Inflammatory dermatoses are a frequent indication for skin biopsy and present diagnostic challenges due to overlapping clinical and histopathological features. Accurate diagnosis relies on clinicopathological correlation, often supported by multidisciplinary team (MDT) discussion. The Royal College of Pathologists (RCPath) Tissue pathways for dermatopathology outline national standards for reporting skin biopsies in inflammatory dermatoses. This study aimed to evaluate local compliance with RCPath standards for inflammatory skin biopsy reporting among inflammatory dermatosis cases discussed at skin clinicopathological conference (CPC) meetings.

A retrospective audit was conducted of all cases discussed at monthly skin CPC meetings between December 2024 and December 2025 (n = 89). Cases with a final histological diagnosis of inflammatory dermatoses were included. Reports were assessed against RCPath-derived standards, including adequacy of request form information, quality of microscopic descriptions, documentation of ancillary investigations and MDT discussion, and turnaround time.

Of 89 skin biopsies discussed at skin CPC meetings between December 2024 and December 2025, 43/89 (48.3%) were identified as inflammatory dermatoses and included in the analysis. Microscopic descriptions met RCPath standards in 43/43 (100%) cases, and ancillary investigations were documented in 27/27 (100%) cases where performed. However, only 8/43 (18.6%) biopsy request forms contained adequate clinical information, defined as documentation of lesion morphology and duration. CPC discussion resulted in diagnostic amendment in 6/43 (14.0%) cases. Turnaround times were prolonged, with only 5/43 (11.6%) reports issued within the seven-day target (mean 44.4 days; median 35 days).

While histopathology report content met RCPath standards, the quality of clinical information provided and prolonged turnaround times represented key areas for service improvement. Improving the completeness of clinical information on biopsy request forms may support more accurate histopathological diagnosis. Skin CPC meetings provide an important forum for diagnostic refinement and clinician education.