Contents Guide to Using This Book ix 1 Biopsy Collection:Why, When, Where and How 1 Biopsy Sample Selection 2 Why and When to Collect a Biopsy Sample 2 Where to Collect a Biopsy Sample 2 How to Collect a Biopsy Sample 4 Biopsy Sample Fixation 13 Standard Fixation Techniques 13 Fixation for Suspected Immune Mediated Skin Diseases 14 Fixation for Selected Tumor Studies or for Selected Infectious Agents 14 Clinical History 15 Sample Shipment 15 Microscopic Interpretation of a Biopsy Sample 16 Limitations of Dermatopathology 18 Value of Referral to or Consultation with a Dermatology Specialist 18 Ancillary Procedures to Facilitate Diagnosis 18 Common Errors of Sample Collection and Submission 19 2 Clinical Lesion Definitions, Recommended Methods of Biopsy Sampling, and Representative Histologic Lesions 21 3 Histopathologic Responses of the Skin to Injury 53 Histopathologic Responses of the Epidermis to Injury 54 Histopathologic Responses of the Dermis and Vessels to Injury 76 Histopathologic Responses of the Adnexa to Injury 90 Histopathologic Responses the Panniculus (Subcutis) to Injury 102 4 Tumors and Tumor-like Masses of the Skin 107 Tumors of the Skin 109 Epidermis 115 Adnexa 121 Dermis, Vasculature, Nerve Tissue, Subcutis 129 Bone Marrow Derived Cells 137 Tumor-like Masses of the Skin 144 Cysts 144 Hamartomas 148 Other Tumor-like Lesions 154 5 Laboratory Techniques for Tissue Processing and Staining 159 Sample Arrival at the Laboratory 160 Gross Evaluation and Trimming of Sample 160 Sample and Request Review 160 Sample Trimming 161 Tissue Demineralization 161 Tissue Processing and Histochemical Staining Techniques 162 Immunostaining Techniques (Direct Immunohistochemistry and Immunofluorescence) for Autoimmune Skin Disease 165 Immunohistochemical Staining Techniques for Tumor and Tumor-like Conditions 167 Immunohistochemical Staining Techniques for Infectious Agents 168 Other Techniques 168 6 Glossary 169 7 Differential Diagnosis of Clinical Lesions and Lesions in Selected Anatomic Locations 177 Appendices 185 A. Dermatopathology Submission Form 186 B. Suppliers 187 C. Case Review 189 Recommended Readings 195 Index 197
Contents Guide to Using This Book ix 1 Biopsy Collection:Why, When, Where and How 1 Biopsy Sample Selection 2 Why and When to Collect a Biopsy Sample 2 Where to Collect a Biopsy Sample 2 How to Collect a Biopsy Sample 4 Biopsy Sample Fixation 13 Standard Fixation Techniques 13 Fixation for Suspected Immune Mediated Skin Diseases 14 Fixation for Selected Tumor Studies or for Selected Infectious Agents 14 Clinical History 15 Sample Shipment 15 Microscopic Interpretation of a Biopsy Sample 16 Limitations of Dermatopathology 18 Value of Referral to or Consultation with a Dermatology Specialist 18 Ancillary Procedures to Facilitate Diagnosis 18 Common Errors of Sample Collection and Submission 19 2 Clinical Lesion Definitions, Recommended Methods of Biopsy Sampling, and Representative Histologic Lesions 21 3 Histopathologic Responses of the Skin to Injury 53 Histopathologic Responses of the Epidermis to Injury 54 Histopathologic Responses of the Dermis and Vessels to Injury 76 Histopathologic Responses of the Adnexa to Injury 90 Histopathologic Responses the Panniculus (Subcutis) to Injury 102 4 Tumors and Tumor-like Masses of the Skin 107 Tumors of the Skin 109 Epidermis 115 Adnexa 121 Dermis, Vasculature, Nerve Tissue, Subcutis 129 Bone Marrow Derived Cells 137 Tumor-like Masses of the Skin 144 Cysts 144 Hamartomas 148 Other Tumor-like Lesions 154 5 Laboratory Techniques for Tissue Processing and Staining 159 Sample Arrival at the Laboratory 160 Gross Evaluation and Trimming of Sample 160 Sample and Request Review 160 Sample Trimming 161 Tissue Demineralization 161 Tissue Processing and Histochemical Staining Techniques 162 Immunostaining Techniques (Direct Immunohistochemistry and Immunofluorescence) for Autoimmune Skin Disease 165 Immunohistochemical Staining Techniques for Tumor and Tumor-like Conditions 167 Immunohistochemical Staining Techniques for Infectious Agents 168 Other Techniques 168 6 Glossary 169 7 Differential Diagnosis of Clinical Lesions and Lesions in Selected Anatomic Locations 177 Appendices 185 A. Dermatopathology Submission Form 186 B. Suppliers 187 C. Case Review 189 Recommended Readings 195 Index 197
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