The study by Piccolo et al1 comparing telepathology with conventional histopathologic diagnosis shows the lack of accuracy of telepathology on prognostically important diagnoses. Case 17, a squamous cell carcinoma, was correctly diagnosed by only 12 of 16 experts using telepathology. By conventional histopathology, it was diagnosed correctly by 15 of 16 experts. Case 6, pityriasis lichenoides, was misdiagnosed as mycosis fungoides by 7 experts using telepathology, but by conventional histopathology, it was misdiagnosed by 4 experts. On the other side of the spectrum, prognostically innocuous lesions such as hemangioma (cases 4 and 11), dermatofibroma (case 13), and angioleiomyoma (case 8) were diagnosed with 100% accuracy by telepathology and in case 12 (hemangioma), by 15 of 16 experts.