Conflicting Diagnoses Regarding My Ongoing Skin Condition
To summarize the situation: Doctor A conducted a biopsy on a skin sample and determined that I have vulvar lichen planus. Conversely, Doctor B, who specializes in vulvar dermatology, firmly believes I do not have this condition after examining me and analyzing my symptoms. Upon mentioning the previous biopsy that suggested lichen planus, she expressed doubt about the accuracy of such tests, insisting that she needs to review the actual pathology report. Her confidence in my diagnosis is so strong that she has opted not to schedule any follow-up appointments, believing instead that my symptoms stem from eczema. This has left me feeling quite perplexed. I had always assumed that biopsies provided conclusive results, but I'm starting to wonder if these pathology interpretations might have some level of subjectivity. Could someone clarify how a false positive might occur in this context? Age: 35, Height: 5'9", Weight: 145 lbs, Non-smoker
Answers (1)
3/25/2025, 12:10:42 AM
OpenHealth AI
It’s understandable to feel perplexed and concerned with conflicting diagnoses about your skin condition. Both dermatologists can provide valuable insights, but it is important to grasp how differing opinions can arise in cases like yours, particularly regarding lichen planus and eczema.
Key Points:
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Conflicting Diagnoses: Both lichen planus and eczema can present similar symptoms on the skin, leading to different interpretations based on clinical examination and biopsy results.
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False Positives in Biopsy: Skin biopsies, while generally accurate, can sometimes yield results that may not fully reflect the patient's condition. For example, inflammation observed in a biopsy could mimic the characteristics of lichen planus, but may actually be due to eczema or other dermatological conditions. Techniques used in processing tissue samples and the interpretation of results can introduce variability.
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Subjectivity in Pathology: Different dermatologists may have varying levels of experience or emphasis in their specialties, which can lead to different interpretations of the same biopsy results.
Next Steps:
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Obtain the Pathology Report: Request a copy of your biopsy pathology report from Doctor A and review it in detail. This can clarify what specific features were noted that led to the diagnosis of lichen planus.
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Seek a Second Opinion: If you still have concerns after reviewing your report, consider consulting a third dermatologist. Ensure this doctor has experience with skin disorders and is willing to evaluate both the clinical presentation and pathology.
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Monitor Your Symptoms: Keep track of your skin symptoms, noting any changes, triggers (like products or environmental factors), and responses to any treatments you may try. This information can be valuable in consultations with healthcare providers.
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Explore Treatments for Eczema: If eczema is indeed a possibility, you might want to start a skincare regime that includes gentle products and regular moisturizing to see if your symptoms improve.
Remember, navigating conflicting medical opinions can be challenging, but you have the right to pursue clarity and effective treatment for your condition. Stay proactive about your health!
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