[Pattern Analysis of Inflammatory Skin Diseases According to A. B. Ackerman-always Up to Date]

Pathologe. 2020 Jul;41(4):301-316. doi: 10.1007/s00292-020-00789-6.
[Article in German]


The exact microscopic diagnosis of inflammatory skin diseases requires the linking of histopathological findings with clinical features. This is not easy when skin biopsies are rarely assessed and the terminology of dermatopathology and dermatology is itself unfamiliar.The infiltrates of almost all inflammatory skin diseases tend to show eight specific patterns in high magnification. By further classifying according to architectural and cytological features, a specific diagnosis can be made in most cases. At the same time, clinically suspected diagnoses are simply excluded or greatly reduced in number. This procedure, starting with the overview magnification and the recognition of clearly defined histomorphological features, corresponds to an algorithm.Another algorithmic approach uses histomorphological changes under high magnification. Here, "nonspecific" findings are added to the pattern analysis as a diagnostic vehicle.Occasionally, inflammatory skin diseases cannot be assessed conclusively with current modern methods. Such pathology reports should be written descriptively and possible differential diagnoses should be mentioned as notes. The report should be written in a language understandable to the clinician.Artificial intelligence, with its ability to transform and integrate extensive clinical as well as image data, will play an important role in the future of decision making, diagnosing, and personalizing medicine. In the field of pathology, it could be seen as a second opinion. It is important that physicians always contribute their opinion where important algorithmic decisions are made, such as in algorithm design, data quality, interpretation, action, and feedback.

Keywords: Algorithmic method; Artificial intelligence; Histologic diagnosis; Inflammatory skin diseases; Pattern analysis.

Publication types

  • English Abstract
  • Review