The Histology of Dermatological Specimens Part 2

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Author: Diana Harrington, BS, HT(ASCP)
Reviewer: Hari D. Patel, MBA, BAS, HT(ASCP)^CM

This course, the second in the dermatological specimens series, addresses the most common concerns of working with dermatology specimens and provides tips to create high quality slides for the dermatopathologist. Explored topics include optimal processing, sectioning, and recut protocols for skin biopsies, shaves, and excisions. The histomorphology of skin is reviewed and commonly used H&E and special stains are discussed. Possible sources of problems are also investigated and solutions are applied to prevent artifacts on skin sample slides.

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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)
Florida Board of Clinical Laboratory Science CE Credit Hours -
General (Histology): 1 hour(s)

Objectives

Describe the optimal processing protocol for skin biopsies and fatty skin excisions, including how fat content and tissue size affect processing.
Explain why accurate embedding of skin samples is critical to diagnosis and describe the best way to embed skin to obtain high quality slides.
Describe the most common sectioning and recutting protocols for shaves, punches, and excisions.
Identify sectioning artifacts, their possible sources, and solutions.
Identity the skin layers and cells of a properly stained hematoxylin and eosin (H&E) slide.
Identify the most commonly used special stains for skin specimens and the cells and structures they highlight.

Course Outline

Introduction to Skin Histology

Introduction to Skin Histology

Review of Skin Histomorphology

The Importance of Understanding Skin Morphology
Overview of Skin Layers
True or False: Distinguishing between skin layers is an essential part of embedding, sectioning, and staining skin tissue.
Place the three layers of skin in order, beginning with the outer layer.

Skin Sample Identification

Identifying Skin Sample Types
Which of the choices describes a skin sample that has a characteristic cone shape that reveals all skin layers?

Skin Paraffin Processing

Paraffin Processing of Formalin-Fixed Skin Samples
Reviewing the Processing Steps
Choosing Skin Processing Schedules
Place the following processing steps in order from beginning to end.

Skin Embedding Techniques

Embedding Skin Tissue
General Embedding Considerations
True or False: Melted paraffin for embedding purposes should be maintained at 10–15°C above the melting point of the paraffin being used.
Skin Embedding Techniques
True or False: Skin excisions are embedded with the cut surface down and gently pressed, edge to edge, so the tissue surface lies flat in one plane.

Skin Sectioning Techniques

Sectioning Skin Tissue
Skin Sectioning Techniques
True or False: Sectioning one block at a time and floating only one block's ribbon(s) on the water bath prevents the tech from accidentally placing on...
Skin Sectioning Protocols
Skin Sectioning Artifacts
Skin Sectioning Troubleshooting
A histologist is reviewing the stained slides. She notices that several of the slides have tissue fragments and incomplete sections of skin. What is/a...

Skin Staining: H&E and Special Stains

Hematoxylin and Eosin (H&E) Stained Skin
Identifying Skin Cells and Structures in Hematoxylin and Eosin (H&E) Stain
Study the skin H&E image, then match the cells and structures to the layer that they are found in.
Special Stains for Skin
Special Stains for Skin: Fungi
Special Stains for Skin: Bacteria
Special Stains for Skin: Spirochetes
Special Stains for Skin: Melanin and Amyloid
Match the resulting color of the finished stain to the name of the stain and what it demonstrates.

Conclusion to Skin Histology

Conclusion

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 medical 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.

The author has no conflict of interest to disclose.

Reviewer Information: Hari D. Patel, MBA, BAS, HT(ASCP)^CM, is the Anatomic Pathology Training Coordinator for NeoGenomics in California, where he develops comprehensive training programs that produce highly skilled, certified histotechnologists. His laboratory career began in the U.S. Navy, serving as a Hospital Corpsman and Histopathology Technician, including leadership roles at high-volume military medical centers and representing the histology profession as a subject matter expert. His experience in healthcare operations, process improvement, and staff development continues in the Navy Reserve. He holds an MBA in Healthcare and a Bachelor of Applied Science in Health Sciences.

Course Description: This course, the second in the dermatological specimens series, addresses the most common concerns of working with dermatology specimens and provides tips to create high quality slides for the dermatopathologist. Explored topics include optimal processing, sectioning, and recut protocols for skin biopsies, shaves, and excisions. The histomorphology of skin is reviewed and commonly used H&E and special stains are discussed. Possible sources of problems are also investigated and solutions are applied to prevent artifacts on skin sample slides.

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Histology CE

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Ribbons from two different blocks on one water bath should be avoided to prevent placing the wrong tissue on the slide.