Comparison of Ex Vivo and In Vivo Dermoscopy in Dermatopathologic Evaluation of Skin Tumors

Haspeslagh, Marc; Vossaert, Katrien; Lanssens, Sven; Noë, Michaël; Hoorens, Isabelle; Chevolet, Inès; Wispelaere, Ines De; Degryse, Nele; Facchetti, Fabio; Brochez, Liève

doi:10.1001/jamadermatol.2015.4766

Cited by 13 publications

(24 citation statements)

References 9 publications

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“…With shorter fixation times, the chance of observing even smaller vessel remnants on EVD increases. In insufficiently fixed biopsy specimens, some vascular red color can still be observed . Loss of red and fine vascular structures was observed in our EVD study as well as by other authors .…”

Section: Discussionsupporting

confidence: 85%

“…Blood vessels of larger diameter that we saw in BCCs were observed by others, too . It was stated that the fixation time could influence the presence of vascular structures in EVD.…”

Section: Discussionsupporting

confidence: 67%

“…Optical clearing of the tissue by methylene glycol, the hydrated metabolite of formaldehyde, during the fixation process results in reduced scattering of the light in collagenous skin tissue, and the resulting deeper penetration of the light might explain the accentuation and appearance of blue and white color . Comparing IVD and EVD images, Haspeslagh et al ., observed increase in white color on EVD images of BCCs that was explained by revealing underlying fibrotic stromal reaction.…”

Section: Discussionmentioning

confidence: 98%

“…Scope and coworkers were the first to publish an observation that dermatoscopy can be applied to fixed tissues in the pathology laboratory . Dermatoscopy after excision of the tumor ( ex vivo dermatoscopy [EVD]) can be applied on fresh tissue specimens or after formalin fixation . It has been reported that in vivo dermatoscopy (IVD) images and EVD images of the skin tumors were comparable .…”

Section: Introductionmentioning

confidence: 99%

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Sensitivity and specificity of ex vivo dermatoscopy: a case series

et al. 2018

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Section: Discussionsupporting

confidence: 85%

“…Blood vessels of larger diameter that we saw in BCCs were observed by others, too . It was stated that the fixation time could influence the presence of vascular structures in EVD.…”

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Sensitivity and specificity of ex vivo dermatoscopy: a case series

et al. 2018

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“…5 The use of dermoscopy has also increased among nondermatologist physicians who actively participate in skin cancer management, such as family physicians. 6–8 …”

Section: Introductionmentioning

confidence: 99%

Enhancing Skin Cancer Diagnosis with Dermoscopy

Wolner

Yélamos

Liopyris

et al. 2017

Dermatologic Clinics

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Synopsis Dermoscopy increases the sensitivity for skin cancer detection, decreases the number of benign lesions biopsied for each malignant diagnosis, and enables the diagnosis of thinner melanomas compared to naked eye examination. Three meta-analyses have all identified that dermoscopy improved diagnostic accuracy for melanoma when compared to naked eye exam. In addition, studies have established that dermoscopy can aid in the detection of keratinocyte carcinomas. Dermoscopy triage algorithms have been developed to help novices decide when a biopsy or a referral is most appropriate. In this chapter we illustrate the dermoscopic features that assist in identifying melanoma and keratinocyte carcinomas.

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Pathologic Evaluation of Skin Tumors With Ex Vivo Dermoscopy With Derm Dotting

Haspeslagh

Hoorens

Degryse³

et al. 2017

JAMA Dermatol

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IMPORTANCE Ex vivo dermoscopy (EVD) with derm dotting (DD) improves clinicopathologic correlation and the quality of diagnosis in skin tumors. OBJECTIVE To compare the diagnostic performance of the standard method of skin biopsy processing with the practice of EVD with DD. DESIGN, SETTING, AND PARTICIPANTS This retrospective study compares the diagnostic performance in 6526 skin biopsy specimens examined from 2008 to 2010 with a standard method of processing with 8584 biopsy specimens examined in 2015 with EVD and DD. Data were analyzed from January 1 to March 31, 2016. A total of 15 110 skin biopsy specimens were included. The biopsy specimens from 2008 to 2010 were processed in a hospital-based general pathology laboratory; the biopsy specimens from 2015 were processed in a private dermatopathology laboratory. Biopsy specimens from both periods were diagnosed by the same dermatopathologist. MAIN OUTCOMES AND MEASURES The primary outcome measures were clinicopathological characteristics, usefulness of EVD with DD, and turnaround times (TATs). RESULTS Use of EVD with DD increased the detection of positive section margins in nonmelanoma skin cancer from 8.4% to 12.8%. The most significant increase was seen in Bowen disease, invasive squamous cell carcinoma, and a superficial type of basal cell carcinoma (BCC). With EVD and DD, a specific clinicopathologic diagnosis was made in 27.7% of nevi compared with only 10.3% using the standard method. The incidence of moderately and severely dysplastic nevi increased from 1.0% to 7.2% and from 0.6% to 1.4%, respectively. The detection of ulceration in melanomas with thicker than 1 mm increased from 24.0% to 31.3%. The number of nevi-associated melanomas increased from 15.5% to 33.3%. The number of collision lesions from 0.07% to 1.07%. The TAT for nevi decreased from 2 days to 1 day, for melanomas from 5 days to 2 days, and for BCC from 2 days to 1 day. CONCLUSIONS AND RELEVANCE Ex vivo dermoscopy and DD with adapted sectioning in a dermatopathology setting allows a more accurate and less time consuming histopathologic diagnosis of skin tumors. These findings suggest that pathologists involved in skin tumor evaluation should be encouraged to learn dermoscopy and replace random transverse cutting with lesion-specific and DD-guided cutting.

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Comparison of Ex Vivo and In Vivo Dermoscopy in Dermatopathologic Evaluation of Skin Tumors

Cited by 13 publications

References 9 publications

Sensitivity and specificity of ex vivo dermatoscopy: a case series

Sensitivity and specificity of ex vivo dermatoscopy: a case series

Enhancing Skin Cancer Diagnosis with Dermoscopy

Pathologic Evaluation of Skin Tumors With Ex Vivo Dermoscopy With Derm Dotting

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