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What causes errors in dermatopathology practice?


Dr. Mona Abdel-Halim

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Errors can happen during our practice and I believe nobody is exempted from making an error. However, the most important thing is to identify the cause of this error and to work on it to avoid it happening again.

Sometimes the cause of the error is in the dermatopathologist himself. Lack of sufficient skills, overworking and exhaustion or lack of second opinion are the main reasons for such errors. It is a sacred mission for anyone of us who has chosen to be a doctor to continuously upgrade himself and increase his skills by continuous self learning. Avoiding overworking and exertion is important to ensure proper thinking and evaluation of slides. Having somebody beside you to share with him/her a second opinion is definitely important.

However, there are other reasons for errors that are in the specimen itself or in the processing. Sometimes you find no sample in the bottle, or an inadequate sample, or sometimes the site from which the biopsy was taken is a wrong site. A common cause of error also is encountered in blistering disorders where biopsies are not taken from small intact blisters thus leading to rupture of the blister and possible malorientation. In such situations you should refer to the clinicians immediately and ask for another biopsy before rushing and making wrong interpretations. Sometimes, when there is discrepancy between the clinical description and what you see on the slide, you have to do deep sectioning before writing your report. I found deep sectioning very crucial in many situations. Malorientation of the specimen in the paraffin will cause an error in the interpretation. Bad fixation or staining may also lead to errors. Our field is very important and crucial for patients' lives, we have to take care of all causes of errors and try to overcome them as much as we can..
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