www.derm101.com: A growing online resource for learning dermatology and dermatopathology

INTRODUCTION

Dermatology and dermatopathology are subjects that can be mastered only by observing numerous cases and histopathology sections respectively along with conceptual understanding of the disease. The illustrious textbooks of this very visual branch of medicine are expensive and inaccessible to most residents and even many clinicians in developing nations. The internet is an easily affordable communicative resource these days and this makes it a need of the hour to have an educative and authoritative source of information available on the internet on which the residents and practitioners can rely.

It was as recently as 1999 that Dr. A.B. Ackerman decided to establish an Internet portal dedicated to the learning and teaching of dermatopathology. The increasing availability of the internet worldwide as well as the possibility to create interactive teaching devices were two of the main reasons for that decision. Since its launch in 2000, the web site www.derm101.com has undergone several revisions and new contents have been included. It has developed into a highly dynamic site to which new material is added every month. It is fair to say that within 6 years, www.derm101.com has become the most comprehensive online library of dermatology resources. In this article, we will give a brief overview of the resources that are currently available on www.derm101.com.

A Clinical Atlas OF 101 Skin Diseases

The atlas edited by A. Bernard Ackerman, Helmut Kerl, Jorge Sanchez et al is available online in a Second Edition that features more than 3,000 color photographs, 200 photomicrographs and newly revised text. Conceptual understanding of disease pathogenesis and clinical manifestations that has been projected in the "Unifying concepts" present towards the end of each topic, is a unique section of this textbook. The organization of the diseases in this atlas is alphabetical because the authors concluded that all other attempts to classify skin diseases clinically, e.g., "eczematous dermatitis," "disorders of cell kinetics," "benign neoplasms and hyperplasias," and "precancerous lesions and cutaneous carcinomas," have failed as they lack logic and consistency.

The authors sought deliberately to capture as many facets as possible of every disease under consideration and they included photographs of lesions in various skin types. Each chapter begins with a terse definition of the disease itself, followed by a photograph that portrays typical clinical features of a particular disease. Accompanying it are low and high magnification histopathologic photomicrographs of the disease that serve as a vehicle to accomplish correlation with the gross findings. Thereafter, clinical photographs are presented in sequence, namely, distribution, arrangement and configuration of lesions and attributes of individual lesions. A statement about the biologic course of the disease is followed by a comment that seeks to integrate the morphologic findings, clinically and histopathologically, with the biologic course. Lastly, a few lines are devoted to practical, effective therapy, the rationale for which is predicated on a grasp of morphologic and biologic aspects of a particular disease.

INTERACTIVE QUIZZES

Each interactive quiz covers clinical and histopathological aspects in the same patient and of the same lesions. All of the pictorial material is utilized by A. Bernard Ackerman in a manner that maximizes its effectiveness for teaching. Integral to the method is setting forth in comprehensible fashion, dependable criteria for diagnosis clinically and histopathologically. In some instances, the clinical features are explained on the basis of the histopathologic findings and vice versa in others. In still others, attention is given to differential diagnosis, clinically and histopathologically. Options for therapy predicated on the knowledge of histopathologic findings are offered for the particular condition. Each quiz ends with a section titled, "Lessons" in which concepts that cannot be found in "standard textbooks" are introduced and explored.

HISTOLOGIC DIAGNOSIS OF INFLAMMATORY SKIN DISEASES

The 3 ^rd edition of this classic work by authors A. Bernard Ackerman, Almut B φer, Bruce Benin and Geoffrey J. Gottlieb, endeavors to capture in itself the best, conceptually, of what was delivered in each of the prior editions. The first part consisting of nine chapters is available in print format as well as on the website. It is designed to be read through from the preface to the end of Chapter 9 and it provides a sweep-through diagnosis of inflammatory skin diseases by way of pattern analysis. Completely revised basic patterns are presented and illustrated richly showing in direct comparison, numerous diseases that may pose a problem in differential diagnosis. In contrast, Chapters 10 and 11 of this third edition are available only online. They are organized according to the diseases and provide thousands of images that are designed to serve as a reference manual. The contents of these chapters can be approached either by the name of the disease or by clicking through algorithms as they may be used in the daily practice at the microscope.

CLUES TO DIAGNOSIS IN DERMATOPATHOLOGY

The second edition of three volumes by A. Bernard Ackerman dedicated to clues to diagnosis in dermatopathology presents subtle hints and helpful observations for coming to a specific histopathologic diagnosis with near surety. The material is presented in quiz format, each clue being illustrated with histopathologic and clinical images and enriched with information about the variability of a disease and about common pitfalls in diagnosis and differential diagnosis.

Resolving Quandaries in Dermatology, Pathology and Dermatopathology

Brief essays by A. Bernard Ackerman and various coworkers clarify enigmas in dermatology, general pathology and dermatopathology by way of analyzing scrupulously what has been written about a particular subject in the past and present.

Dermatopathology: Practical and Conceptual

Dermatopathology: Practical and Conceptual is a peer-reviewed quarterly online journal of dermatology and dermatopathology founded and edited for many years by A. Bernard Ackerman who, in 2004 passed over the editorship to Almut B φer. Dermatopathology: Practical and Conceptual is dedicated to the advance academically of dermatopathology and its near relatives: dermatology and general pathology. What makes this journal unique is (1) its requirement that everything published be marked by something original, be it an observation clinically or a clue to diagnosis histopathologically, a report about research or a treatise that sets forth an iconoclastic view of what is an accepted vantage universally, a reassessment of conventional criteria for diagnosis or a thesis about a concept that is unifying and (2) its commitment to cutting a swath through the philosophical, sociological, ethical, historical and artistic aspects of dermatopathology, dermatology and general pathology.

DIFFERENTIAL DIAGNOSIS IN DERMATOPATHOLOGY

The 3 ^rd edition of this work by A. Bernard Ackerman highlights histopathologic and clinical distinctions by contrasting pairs of disease. Lead lines are given to facilitate recognition of important diagnostic criteria.

VIDEO LECTURE LIBRARY

The video library provides a series of lectures by A. Bernard Ackerman on various topics. All lectures are rendered slowly and easily comprehensible. The ample number of images livens up the presentation. Each of the subjects is engaged in didactical fashion with particular attention paid to the most absorbing aspect of the topic.

Cutaneous Medicine and Surgery: Self Assessment and Review

Over 2,000 original questions that reflect the format and content found in Board Examinations permit a user to test himself / herself using content found in many national tests. Topics and length of tests can be chosen or all of the questions offered on one subject can be taken by clicking on a chapter title.

THERAPEUTIC STRATEGIES IN DERMATOLOGY

The authors of "Therapeutic strategies in Dermatology", Bruce U. Wintroub and Timothy G. Berger, provide individual primers on how to treat diseases of the skin, from first-line therapies to solutions for complex cases. The chapters are designed to be easy-to-use "how-to" whitepapers for the physician, resident, physician assistant, nurse practitioner or student who must treat patients with skin disease. Each whitepaper has four basic parts: initial therapy, alternative (initial) therapy, subsequent therapy and pitfalls. The authors invite readers to share their own experiences with treatment of skin diseases with them.

CLINICAL CASE STUDIES

In this novel exercise, patients can be tracked from diagnosis to therapy using clinical images. Patients presented here have less common diseases as well as common ones. Treatments demonstrated include well-established options for therapy as well as unconventional or less widely performed procedures. Post-treatment documentation of clinical lesions shows the efficacy of the therapy applied. A new case is added every month.

Comment

Overall, the web site www.derm101.com is a multifaceted resource for learning dermatology and dermatopathology. Clinical aspects including treatment of skin diseases are covered fully with special emphasis being given to teaching and training and to the practical relevance of the information provided. For students of dermatopathology, this web site offers diagnostic criteria for diseases of the skin with an incomparable number of high quality photomicrographs. Users are invited in several ways to participate actively in the site content, e.g, in the form of interactive quizzes, self assessment and board review or by submitting observations or critical thoughts to the online journal Dermatopathology: Practical and Conceptual. CME credit is available for interactive quizzes and Cutaneous Medicine and Surgery: Self Assessment and Review. Derm101.com is a highly dynamic web site with new material being added several times a month. E-mail alerts are sent out to subscribers whenever new content is added to the web site.

The web site derm101.com is made possible in part by grants provided by the companies Galderma^© and Ameripath^© . The costs of subscription to derm101.com are 10 US$ per month. Interested colleagues can get a free trial membership for three months which is offered on the front-page of the site.

Attention Residents In Dermatology !

Residents in dermatology all over the world are provided free access to www.derm101.com by Galderma^© . For further information, please contact customerservice@derm101.com