Pigmented lesions in actinically damaged skin. Histopathologic comparison of biopsy and excisional specimens

Somach, S. C.

doi:10.1001/archderm.132.11.1297

Cited by 44 publications

(56 citation statements)

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“…13,14 Incisional biopsy specimens of lentigo maligna often fail to show the areas with the most advanced histologic changes. 15 Consequently, inaccurate microstaging can occur because of sampling errors within clinically heterogeneous lesions. 16 On the other hand, an excisional biopsy may be impractical in lesions that are large or in areas of cosmetic concern.…”

Section: Biopsy Methodsmentioning

confidence: 99%

Variation in the Diagnosis, Treatment, and Management of Melanoma In Situ

Charles

Yee²,

Dusza³

et al. 2005

Arch Dermatol

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Section: Biopsy Methodsmentioning

confidence: 99%

Variation in the Diagnosis, Treatment, and Management of Melanoma In Situ

Charles

Yee²,

Dusza³

et al. 2005

Arch Dermatol

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“…The effect of ultraviolet irradiation on promoting melanocyte activation, and the impact or psoralens and plant products such as in the setting of phytophotodermatitis or psoralen with ultraviolet light (PUVA) therapy are two such pitfalls. 46,47 Another is the histologic appearance of nevi of peculiar anatomic sites (ie milk line, flexural, auricular, genital, or acral nevi). 33,48,49 All may generate a histomorphology suspicious for melanoma.…”

Section: Overdiagnosismentioning

confidence: 99%

Medicolegal aspects of neoplastic dermatology

Crowson

2006

Modern Pathology

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Medical malpractice litigation is rising at an explosive rate in the US and, to a lesser extent, in Canada. The impact of medical malpractice litigation on health care costs and the cost of insurance is dramatic. Certain specialist categories are becoming uninsurable in some parts of the US, while in others, clinicians are retiring early, restricting or changing practice or changing states of residence in consequence of medical malpractice claims and of the cost and availability of insurance. This, in turn, has had the real effect of denying care to patients in some communities in the US. Some 13% of all medical malpractice claims relate to one area of neoplastic dermatopathology, specifically, melanocytic neoplasia. Certain steps can be taken by pathology laboratories to reduce, but never completely eliminate, the risk of medical malpractice claims. In this review, attention is paid to the source of medical malpractice claims and an abbreviated approach to specific strategies for risk management is presented.

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“…10,11 It would be hoped that partial biopsies would sample the most clinically atypical portion of the suspicious pigmented lesion, but the most clinically suspicious portion does not necessarily coincide with the histopathologically most atypical portion. 12 Therefore, it is not surprising that partial biopsies yielding an atypical nevus upon histopathologic analysis have revealed melanoma on complete excision. 12,13 Therefore, it appears wise, when possible, to perform complete clinical removal of suspicious pigmented lesions so that adequate histopathologic analysis may be performed.…”

Section: Age Of Patients In Relation Tomentioning

confidence: 99%

“…12 Therefore, it is not surprising that partial biopsies yielding an atypical nevus upon histopathologic analysis have revealed melanoma on complete excision. 12,13 Therefore, it appears wise, when possible, to perform complete clinical removal of suspicious pigmented lesions so that adequate histopathologic analysis may be performed. Complete removal of some pigmented lesions can be cosmetically problematic, and the performance of an appropriate biopsy must be tempered with clinical judgment of the benefits and risks involved.…”

Section: Age Of Patients In Relation Tomentioning

confidence: 99%