Saturday, September 25, 2010

Introduction


The video below gives you an overview of the site and how we intend to present the material to you. Try increasing the 360 number below to 720 and click on the box with the arrows pointing out to view this video full screen in high definition. Press ESC on your computer to go back to normal. Try pressing pause to let it load a bit if you have a slow connection to have uninterrupted viewing in full screen HD mode!




Medical Dermatopathology on the contrary is much easier! If a rash is red and scaly the pathology will be in the epidermis and the condition will be under the mnemonic PMs PET(AL)  See Dermatology Made Simple for the relevant diseases under this mnemonic.
If the condition is red but non scaly then the pathology is in the dermis or fat tissue and the mnemonic CUL DVA EVIE applies . Again see Dermatology Made Simple.


It has been said that if a particular diagnosis is not in a pathologist's differential diagnosis possibilities for a slide then the diagnosis is likely to be missed! 

The use of these clinical mnemonics makes the likeliehood of that happening much less. The mnemonics can be enlarged a bit more depending on the needs of the person using them. We have a simpler variant for medical students, but steadily more detailed ones for GPs, Dermatologists and Dermatopathologists. 

For a Dermatopathologist look at the path slide to see where the pathology is. Decide if a Tumour or Inflammatory. If Inflammatory and the pathology is in the epidermis then the PMs PET (AL) applies for the clinical diagnosis in most cases. Sometimes interface pathology will irritate or damage the epidermis sufficiently to  cause either epidermal necrosis or vesicles so the Blistering mnemonic ICI should also be considered if these features are seen. 

If the pathology is in the dermis or fat layer then CUL DVA EVIE will give you the clinical diagnosis but the range of possibilities is greater! This range can be cut down by looking for inflammatory reaction Patterns and it is these that we will learn through using this website! Learn the mnemonics and learn to look at a slide to decide if the pathology is epidermal or dermal or in fat and dermatopathology becomes not only manageable but also relatively easy. 












For the Dermatopathologist to really help you , you need to submit an adequate specimen. Your options are punch, shave, incisional or excisional biopsies. You also need to submit a reasonable history of the case and some Differential Diagnoses. The video below looks at the different types of skin biopsies.