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Dr. Phillip McKee's Blog

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Dysplastic nevi: to re-excise or not

Dysplastic nevi are often graded as showing mild, moderate or severe atypia. They may be associated with an increased risk of melanoma particularly in a familial setting but also one not uncommonly sees a dysplastic nevus adjacent to a melanoma suggesting progression. Although it is assumed by many that there is a progression through the varying degrees of atypia to [i]in situ[/i] and eventually invasive melanoma, this matter has not been fully resolved. With this as a background, the dermato

Dr. Phillip McKee

Dr. Phillip McKee

Nevoid melanoma

Nevoid melanoma is one of the most important and difficult variants of melanoma. When lecturing, I define it as “a melanoma that you diagnosed as a nevus and wish you hadn’t”! Very commonly, it is a diagnosis of retrospect when a previously diagnosed nevus recurs and the correct diagnosis comes out. I had a mantra when I started my signout reminding myself of conditions I always should bear in mind when looking at the cases- don’t forget nevoid and desmoplastic melanoma (never report

Dr. Phillip McKee

Dr. Phillip McKee

Overseas experience

After I left Brigham and Women’s Hospital in Boston, I spent 3 months reporting all of the dermatopathology in the Department of Pathology at the Wits University Hospital in Johannesburg, South Africa as a guest of Wayne Grayson. What an amazing experience. Having left the Ivory Tower of Boston where melanocytic pathology and cutaneous T-cell lymphoma were my bread and butter, I entered a whole new world. I was reminded very quickly as to why I had embarked on a career in dermatopathology a

Dr. Phillip McKee

Dr. Phillip McKee

Clinicopathological correlation

Clinicopathological correlation is often the basis of accurate dermatopathological diagnosis. But who should perform this correlation? The dermatologist, the dermatopathologist or both? In my experience, in difficult cases, particularly when no clinical information is given, the pathologist often writes a descriptive report followed by the phrase “clinicopathological correlation is required”. This has major disadvantages. Firstly, no specimen should be sent to the laboratory without a f

Dr. Phillip McKee

Dr. Phillip McKee

Atypical nevi

Everyone has his/her hobby horses and I am no exception. My [i]bête noire[/i] is use of the term atypical in melanocytic pathology. The best place to start is by defining typical: [indent=1]1. representative[b]:[/b] having all or most of the characteristics shared by others of the same kind and therefore suitable as an example of it[/indent] [indent=1]2. characteristic[b]:[/b] characteristic of an individual person or thing[/indent] In the context of melanocytic nevi, the common or b

Dr. Phillip McKee

Dr. Phillip McKee

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