The Histology of Dermatological Specimens - Part 1

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Author: Diana Harrington, BS, HT(ASCP)
Reviewers: Brooke Eguia, BS, MS, HTL(ASCP); Carla Shoffeitt, MSM, HT(ASCP)

A wide variety of topics on skin are discussed from morphology and grossing to Mohs surgery. The goal of this course is to expose histotechnologists and other pathology laboratory personnel to the various aspects of dermatopathology and shed light on the early stages of skin specimen processing.

Continuing Education Credits

Objectives

  • Describe the various specimen types received in the dermatopathology laboratory and why it is important to understand skin morphology.
  • Summarize the various steps taken to maintain patient/specimen integrity and accuracy throughout the collection and grossing process.
  • Identify the different layers of skin and the various cells that make up each layer.
  • Define the most common grossing protocols for biopsy shaves and punches of various sizes.
  • Describe how excisions are grossed, with orientation and without, including the identification of potential grossing errors and how to prevent them.
  • Define the Mohs technique used in dermatology.
  • Compare and contrast the various steps of Mohs processing and paraffin processing.

Course Outline

  • Introduction to Skin
      • The Field of Dermatology
      • Skin Cancer Facts, Figures, and Estimates
      • Skin Facts and Functions
      • The majority of specimens submitted to the dermatopathology laboratory are biopsies of suspicious lesions and cutaneous tumors, as well as excisions o...
      • Skin is the human body's largest organ. What are its main functions? (Choose all that apply.)
  • Skin Sample Collection and Processing
      • Skin Specimen Collection: Biopsies and Excisions
      • Overview of Collection Procedures
      • Skin Sampling Procedures
      • Which of the statements are TRUE and reflect the correct collection procedures outlined in this course. (Choose all that apply.)
      • Match the surgical procedure to the shape and characteristics of the sample produced.
  • Skin Histomorphology
      • Skin Layers: Overview
      • Place the following skin layers in order, starting with the outer layer and ending with the inner layer furthest from the surface of the skin.
      • Epidermis
      • The most common type of cell found in the epidermis is called the keratinocyte.
      • Dermis
      • Subcutis (Hypodermis)
      • Which of the following cells or structures are NOT characteristic of the dermal layer?
      • Relevance of Skin Morphology in the Laboratory
  • Skin Grossing Techniques - Biopsies
      • Gross Examination: General Considerations
      • Gross Examination of Shave, Punch, and Curettage Specimens
      • A shave biopsy is measured during the gross examination and the dimensions are 14 mm x 11 mm x 4 mm. The grossing tech should trisect this shave biops...
  • Skin Grossing Techniques - Excisions
      • Grossing Skin Excisions Without Orientation
      • One color of ink can be used for excisions without orientation indicators and the distal tips can be submitted in one cassette.
      • Grossing Skin Excisions With Orientation
      • Commonly, the excision that has an indicator on one of the edges can be treated like the face of a clock, and arbitrarily assign the 12 o'clock to tha...
  • Prevention of Skin Grossing Errors
      • Prevention of Errors During Gross Examination
      • Errors in patient or specimen identification are not the responsibility of the grossing tech, since such errors should be addressed and corrected by r...
  • Mohs Skin Surgery
      • Mohs History
      • Mohs Surgery Overview
      • Mohs Procedure versus Standard Excisions
      • The goal of Mohs surgery is to precisely excise the affected area while preserving normal surrounding tissue.
      • Which of the following statements are TRUE with regard to Mohs surgical excisions? (Choose all that apply.)
  • Conclusion
      • Summary of Dermatological Histology
  • References
      • References

Additional Information

Level of instruction: Basic

Intended audience:  Clinical laboratory histotechnologists, histotechnicians, and other medical laboratory personnel who have an interest in this subject matter. This course is also appropriate for histology and clinical laboratory science students, pathology residents, and practicing pathologists.

Author information: Diana Harrington, BS, HT(ASCP) is a histotechnologist at The Dermatology Center of Indiana. Since graduating from Indiana University, she has worked in various hospital laboratories as a medical technologist and histotechnologist. Her experience led her to teach IU students as a Clinical Education Supervisor and create the Histotechnology Program as Program Director for Keiser University in Florida.

Reviewer information: Brooke Eguia, BS, MS, HTL(ASCP) is the Pathology Technical Supervisor at Fairview Southdale Hospital in Edina, Minnesota. She graduated from St. Cloud State University with a Bachelor of Science degree in general biology and from Capella University with a Master of Science in Human Service with a specialization in Health Care Administration. As a primary health career mentor to high school students, Brooke satisfied her desire for training and teaching histotechnicians and also worked as adjunct faculty at Rasmussen College, as a Medical Assistant laboratory techniques instructor. Most recently, she has focused on proctoring histology students in clinical/classroom progress and exam preparation.

Review information: Carla J. Shoffeitt, MSM, HT(ASCP) is the Manager of the Pathology Department of Emory St. Joseph’s Hospital of Emory Healthcare in Atlanta, Georgia. She holds a Master of Science Degree in Healthcare Management as well as a Bachelor of Science degree in Biology from Troy University, Troy, Alabama. She is certified as a Histotechnician and has over 25 years of experience in the field of Histology.

Course description: A wide variety of topics on skin are discussed from morphology and grossing to Mohs surgery. The goal of this course is to expose histotechnologists and other pathology laboratory personnel to the various aspects of dermatopathology and shed light on the early stages of skin specimen processing.

This course is part of:
Histology CE
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