[center][b][i]Mona R.E. Abdel Halim[/i][/b][/center]
[center][b][i]MD Dermatology, Diploma of Dermatopathology (ICDP-UEMS)[/i][/b][/center]
Dermatopathology is a very challenging discipline that requires complete dedication, extensive practice and continuous reading. However, the most important tool each dermatopathologist need is the ability to achieve good clinical correlation.
The clinical picture to a dermatopathologist is equivalent to the gross pathology of a specimen sent to a genera
Some months ago, a colleague shared a nail biopsy with me. To me it looked like melanoma in situ. It was seen at a consensus conference we have every week with other institutions in the Houston area. Everybody who saw it thought it was melanoma in situ. The problem was that the patient was an eleven-year-old boy.
Given the age of this child, this case was sent in consultation to other experts. One expert opined that it was a junctional nevus with features of pigmented spindle cell nevu
I currently have the privilege of sitting with Dr. Richard Carr in Warwick and looking at his cases/ slide collection. This is my first week and have to say that so far, the experience has been absolutely brilliant!
I would like to share an interesting thought that crossed my mind this morning after seeing quite a dramatic case of a drug induced bullous disorder. We all are aware that drugs can mimic a myriad of cutaneous disease patterns including dermatitis, psoriasiform, lichenoid, bullous
One of the challenging situations that face dermatologists is how to solve the case of the mysterious Red Man??!! Do you know who the Red Man is??!!
The Red Man is a term used to describe patients with erythroderma or exfoliative dermatitis. Erythroderma is not a disease by itself, but a severe state of skin irritation that represents morphologic presentation of a variety of cutaneous and systemic diseases including both inflammatory and malignant conditions. The great challenge in such condi
Boris Goldovsky, a man I was unaware of until a few minutes ago, made an important dermatopathologic contribution (without meaning to). He lived from 1908 to 2001, and was a famous conductor and producer of opera. It is reported that he had a piano student who played bar 78 from Brahms Op 76 No.2 incorrectly – or so Goldovsky believed. He asked his student to play it correctly, and the student showed Goldovsky that he had played the notes exactly as they were printed on the score. It was l
I came across an interesting case last week that I would like to share with you. A female patient 58 years old was referred to me and my colleague, Dr Eman El Nabarawy, with a lesion on the vulva that had been there for 15 years. The patient was diagnosed by her gynecologist to have genital wart (condyloma), in spite of the much localized nature of the lesion and the very long duration. The patient being a widow for 5 years with no sexual relations was not convinced and seeked the advice of a de
Almost every dermatopathologist has had this feeling. You go to a meeting, for example, and hear a talk about the diagnoses which were missed and the often disastrous consequences that ensued – both for the patient and for the dermatopathologist, legally, financially, and morally. Nobody wants to miss important diagnoses. This is never more so than when it comes to melanocytic lesions. I usually return from dermatopathology meetings with that Sixth Sense-esque feeling of I-see-melanomas (t
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 requiredâ€. This has major disadvantages. Firstly, no specimen should be sent to the laboratory without a f
Dermatopathology is an interesting branch with which one develops a special passion! A passion that make you live with cells running in front of your eyes, tissue reaction patterns puzzling you day and night, lovely adnexal tumors dancing in your visual memory, scary yet pretty looking malignant tumors popping in front of you every now and then. When you love dermatopathology, you take it with you wherever you go! Just see:
• You enjoy a cup of tea with your best friends, you look at the
I have been asking myself if there are other ways to learn dermatopathology and recognize histological patterns than just listening to a professor or expert discuss a topic, or going to tedious lectures in which 30 or more minutes of intense concentration are necessary. As a consequence, I have been looking other options such as experience-based learning.
Experience is a noun or verb which was first used in the 14th century, and derives from the latin word experientia, which by definition i
In 2002 or thereabouts, I saw a patient who fundamentally changed the way I think of, and diagnose dysplasias and invasive carcinomas. More about dysplasias later. Prior to me seeing her, I had received 2 biopsies from this middle aged woman for a lesion on the buccal mucosa within a short period of time, and each time, I had diagnosed it as “hyperkeratosis, acanthosis and chronic inflammation†without further comment. The oral surgeon sent the patient to me to be examined.
On examinatio
Imagine you have been given a task as follows: Rearrange the following words to form another word, but do not attempt to unscramble a word further down the list until you have successfully solved the preceding word. Here are the words: “whirl,†“slapstick,†and “cinerama.†Unless you have a brain disorder that makes you incredibly, even supernaturally smart, I am willing to bet that you will find it difficult, if not impossible to unscramble the words “whirl†and “slapstickâ€
Thank you for the additional discussion of this case (I think it was 6th July which was a regressing KA). I could spend a very long time discussing KA v's SCC.Firstly a serious caveat - I am not sure the diagnosis is safe in the hands of experts let alone non-experts to be honest!That said we in Warwick are (currently) firmly in the camp that KA is a distinct Clinical-Pathological diagnosis.Provided a lesion is typical clinically and histologically we can make a confident diagnosis (in the know
[center][b][i]Mona R.E. Abdel Halim[/i][/b][/center]
[center][b][i]MD, Diploma of Dermatopathology (ICDP-UEMS)[/i][/b][/center]
This area in dermatopathology has been always challenging to me. Many dermatopathologists consider large plaque parapsoriasis (LPP) equivalent to early patch stage mycosis fungoides (MF). I do believe that they are separate entities.
In Egypt, we see lots of cases presenting with light red-brown or salmon pink patches, of variable sizes, mostly larger than 5 cm, wi
To start this blog I will quote Dr. Paola Domizio [i]“ What makes a good pathologist? First of all, I think you have to be good at pattern recognition... you have to be thorough in your thinking...[/i]â€
So what is pattern recognition, how can someone create a visual thinking, how is memory involved in this process? As dermatopathologists we go through this process every time we look into the microscope or digital images.
How can I identify a pattern or recognize it? A patt
This is an extremely common keratotic lesion seen at sites easily reached with the teeth. Acute bite trauma is usually painful and results in an obvious ulcer. Lesions of morsicatio mucosae oris, however, are caused by chronic habitual chewing and raking of the teeth over the mucosa, or dragging of the tongue over the lower teeth. Patients may not report such a parafunctional habit because this may occur during sleep.
[u]Clinical and Histopathologic Findings[/u]
Lesions present as wh
The unifying theme behind this series of blogs is as follows: dermatopathologists are humans first and dermatopathologists second, and therefore, are as human as everybody else – including those judges that decide the fate of prisoners presenting to Israeli parole boards. I have created the somewhat cheesy term, “skinnectionâ€, to emphasize that some of my blog postings will explore the connection between the mass of psychological data out there and pathologists who focus on the skin.
F
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
