Dermatopathology – the link between ancillary techniques and clinical lesions

Abstract

It is crucial to understand the limitations of each technique and to correlate the results both with pathological findings and the clinical presentation. As such, dermatopathology will remain the important link between benchtop science, available results from ancillary techniques and clinical veterinary dermatology.

Pattern analysis for the diagnosis of inflammatory skin lesions in domestic animals: An overview

“…30,31 While advanced molecular techniques are largely limited to research laboratories in veterinary dermatology, they are gradually being introduced to assist in diagnosis of inflammatory skin diseases in domestic animals. 3,6,8…”

“…However, confirmation of individual subepidermal blistering diseases requires ancillary testing, including immunohistochemistry, indirect immunofluorescence, western blotting or gene sequencing, and immune electron microcopy. 3,25 The cytotoxic pattern, whether "interface" or "panepidermal," is diagnostically powerful, because it generally implies an immune-mediated process effected by cytotoxic-T-cells as in erythema multiforme, some viral skin diseases, and some autoimmune diseases, such as cutaneous lupus erythematosus. 11,33…”

“…30,31 While advanced molecular techniques are largely limited to research laboratories in veterinary dermatology, they are gradually being introduced to assist in diagnosis of inflammatory skin diseases in domestic animals. 3,6,8 It is widely acknowledged in human and veterinary medicine that the light microscopic interpretation of hematoxylin-andeosin-stained tissue sections will remain the mainstay of routine dermatopathology diagnosis. 3,7 While including adjunct methods, such as clonality testing, immunohistochemistry, in situ hybridization, or polymerase chain reaction (PCR) is helpful, the results always need to be interpreted in the context of the histologic changes observed.…”

“…3,6,8 It is widely acknowledged in human and veterinary medicine that the light microscopic interpretation of hematoxylin-andeosin-stained tissue sections will remain the mainstay of routine dermatopathology diagnosis. 3,7 While including adjunct methods, such as clonality testing, immunohistochemistry, in situ hybridization, or polymerase chain reaction (PCR) is helpful, the results always need to be interpreted in the context of the histologic changes observed. 3,6,8 There are many examples demonstrating that relying on adjunct methods alone can lead to incorrect diagnoses of disease processes.…”

“…3,7 While including adjunct methods, such as clonality testing, immunohistochemistry, in situ hybridization, or polymerase chain reaction (PCR) is helpful, the results always need to be interpreted in the context of the histologic changes observed. 3,6,8 There are many examples demonstrating that relying on adjunct methods alone can lead to incorrect diagnoses of disease processes. 4,10 Thus interpretation of histologic features in context with clinical presentation remains a crucial step in veterinary dermatology, whilst keeping in mind that pattern analysis may prove useful in the development of algorithms for computer-assisted diagnosis in the future.…”