By Walter H. C. Burgdorf M.D., Professor Dr. Theodor Nasemann, Professor Dr. Michael Jänner, Dr. Bärbel Schütie (auth.)
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Extra resources for Dermatopathology
The clinician should be aware of what to biopsy and how to biopsy. In most cases, a biopsy specimen should be taken entirely within the borders of a lesion. Even though much can be learned from studying early and late lesions, it probably is most wise for the clinician to sample a mature lesion that has not been excoriated, injected, cauterized, or otherwise damaged. On rare occasions, it is important to sample the active border of a lesion, either to show earliest changes, to avoid artifacts, or to show a transition from abnormal to normal.
Lichen simplex chronicus (p. 72) is the best example of lichenification. 4 Practical Aspects In this chapter, we summarize some of the technical aspects of converting a patient's skin lesion into a microscopic slide, and then interpreting it. Obtaining a Biopsy Specimen Even the best dermatopathologist cannot read an inadequate, poorly preserved, poorly fixed, or poorly produced slide. Nothing is more frustrating to the patient or submitting physician than to hear that a biopsy specimen is unusable.
In either case, it is important to have them absolutely vertically oriented parallel to the knife face to avoid tangential cuts. Other specimens obtained via another fashion must be carefully oriented based on either a diagram or accurate description. Nothing is more frustrating than to obtain a long, skinny ellipse that includes both normal and abnormal skin, and then have the specimen halved so that the interface between diseased and normal tissue is lost. 4. Practical Aspects are called basophilic after the color of the basal cells [not hematoxylinic], but pinkishred areas are eosinophilic).
Dermatopathology by Walter H. C. Burgdorf M.D., Professor Dr. Theodor Nasemann, Professor Dr. Michael Jänner, Dr. Bärbel Schütie (auth.)