Dr. Cynthia Reyes Barron, a dermatopathologist based in El Paso, Texas, shares her journey from medical school to her current practice and discusses her involvement with VisualDx, a comprehensive clinical decision support tool. Dr. Barron highlights her use of VisualDx in both training and practice, emphasizing its utility in exploring clinical and histological differentials, teaching students, and assisting with challenging cases. She praises VisualDx for its search capabilities, extensive image library, and practical benefits for both students and clinicians. In dermatopathology, VisualDx’s integration of clinical and histological images proves particularly valuable for making accurate diagnoses.
Dr. Barron is interviewed by Hannah Riva, is a third-year medical student at Paul L. Foster School of Medicine at Texas Tech University Health Sciences Center El Paso and VisualDx Student Advisory Board member.
Could you share with us about your background and journey to medical school, residency/fellowship, and your current practice?
Dr. Barron: I was born and raised in El Paso, Texas. I obtained a bachelor of science in Chemistry at MIT. Later, I attended medical school at Texas Tech University, Health Sciences Center, Paul L. Foster School of Medicine in El Paso. I completed a residency in anatomic and clinical pathology and fellowship in dermatopathology at the University of Rochester Medical Center (URMC) in Rochester, NY. I now practice in a private pathology laboratory – Pathology Professional Services, in El Paso, Texas and focus on dermatopathology cases.
How were you first introduced to VisualDx?
Dr. Barron: I first encountered VisualDx as a third-year pathology resident. At that point, I had decided to pursue a fellowship in dermatopathology, and I began attending conferences, lectures, and Grand Rounds with dermatology residents. They introduced me to this excellent resource, which many of them had been using since medical school. I learned that Dr. Papier, a dermatologist at URMC, was the CEO of VisualDx, and many of the histology pictures were contributed by the pathologists with whom I had been training.
Could you share with us about your involvement with VisualDx?
Dr. Barron: As a dermatopathology fellow at URMC, I joined the VisualDx Editorial Board. I contributed annotations for some of the histology pictures in order to highlight the specific findings observed for numerous diagnoses. I also took microscopic pictures for rare diagnoses from cases in the files of the Department of Pathology at URMC and submitted them to be added to the catalog of histology pictures in the database.
How did you use VisualDx in your training?
Dr. Barron: I used VisualDx extensively while in the dermatology clinic to explore the differential diagnoses for clinical findings. Being able to compare a patient’s presentation to the images helped me learn how to approach patients, what questions to ask to narrow down the differential diagnosis, and what tests to order. In many cases, sharing the images with patients helped me explain their diagnoses and concerns.
When I was studying for dermatopathology boards, VisualDx was a valuable resource allowing me to review both the clinical and histologic findings in one succinct and complete reference.
How have you used VisualDx in your practice?
Dr. Barron: I often have students sitting at the microscope while I review cases, and I love having VisualDx open and searching for clinical pictures for each diagnosis. Being able to make the clinicopathologic correlation with real cases enriches their experience. Most of the students will not become dermatologists; however, all will encounter patients with skin disease in their daily practice. I can show them how a basal cell carcinoma looks under the microscope, and also how a typical basal cell carcinoma looks on a patient prior to biopsy.
Moreover, there are so many excellent pictures on VisualDx, that I can show students the range of presentations that may be observed clinically for a great number of diagnoses. For example, I can explain the pattern of inflammation in lupus erythematosus under the microscope and then show them pictures of how that inflammation presents on the patient. The lessons are much more valuable when students can make those connections from the histology to the clinical.
Besides being a valuable resource for teaching purposes, I also use VisualDx for challenging cases. There are times when the clinical differential diagnosis and the histologic differential diagnosis do not match. In such cases, I find it useful to explore the findings in VisualDx in order to formulate a differential that makes sense both clinically and histologically. Being able to compare the clinical pictures I receive from dermatologists with those in the VisualDx library often helps support a diagnosis.
What are your favorite features of VisualDx?
Dr. Barron: VisualDx has incredible search capabilities. Searches can be conducted beginning with clinical observations or with specific diagnoses. The differential diagnoses listed can further guide the search and allow for exploration into rare diseases. References are conveniently listed for in-depth research.
The number and quality of images is unparalleled. For a single diagnosis, you may see images from different sites in the body and in patients of different skin color.
How do you think VisualDx is beneficial for students and for clinicians?
Dr. Barron: VisualDx is a practical and reliable resource. Its accessibility and ease of use make it valuable for use in clinics during patient encounters. Students learning dermatology may begin to explore skin disease by systematically reviewing clinical observations and the patient history and comparing the findings to those in the well-documented gallery of images in VisualDx. Moreover, the best tests for a definitive diagnosis and treatment are also summarized under each diagnosis helping both students and clinicians arrive at the best method for helping patients. And the information on VisualDx is regularly updated so the latest findings are available for users.
How have you found VisualDx to be useful in your field of dermatopathology?
Dr. Barron: Although there are pathology resources and databases available, VisualDx provides both histology and clinical images in a concise yet thorough manner. Because the clinicopathologic correlation is so essential in dermatopathology, VisualDx is an ideal resource in the field.
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