Dermatology Emergencies Every Pathologist Should Know

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Topics discussed and timestamps:
**HUGE thanks to viewer Tonia Syrnioti for typing these up for me! Thank you!!!**
Intro 0:00
Cutaneous clues for ischemia 6:06 (epidermal necrosis without any inflammatory changes)
Necrosis of eccrine coil 8:42
Angioinvasive fungal infection 10:05
Thrombotic vasculopathy 21:38
Calciphylaxis 25:50
SJS/TEN 36:50
Staphylococcal skin scalded syndrome 47:38
Pyoderma gangrenosum 51:29
Our paper on Dermatology Emergencies referenced throughout this lecture is available for free on the Archives of Pathology & Laboratory Medicine website: www.archivesofpathology.org/d.... Archives granted permission for me to use the images and quotes from the article in this KZbin video and asked me to include the following statement: “Reprinted from Abate MS, Battle LR, Emerson AN, Gardner JM, and Shalin SC entitled Dermatologic _ Emergencies: What Every Pathologist Should Know, Arch Pathol Lab Med. 2019;143(8):919-942 with permission from Archives of Pathology & Laboratory Medicine. Copyright 2019. College of American Pathologists.”
I gave this lecture live online on April 24, 2020 as part of the CAP Virtual Lecture Series for Pathology Residents. Recording courtesy of the College of American Pathologists (posted on my KZbin channel with their permission). To access the many other excellent lectures in that series, visit:
www.gotostage.com/channel/capvls (access past recorded lectures)
www.cap.org/calendar/virtual-... (register for future lectures)
Please check out my Dermatopathology survival guide textbook: bit.ly/2Te2haB
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@szapary71]

You are great, I love your lectures. I learn a lot. You are doing an amazing job.

[@woloabel]

Great discourse and illustration of some of the medical dermal emergencies. Ischemia with epidermal necrosis clinical presentation with out inflammatory changes due to immunosuppression is nice. A to Z Ischemia to Autoimmune disease processes to Zoster. Pyoderma Gangrenosum is awfully presented but vitally differentiated. Infection is not treated as autoimmunity. It is just so relevant! Arster immer gut ist aber Medicin bester. Ciao!

[@rajanchopra2193]

Many thanks Dr Gardner and CAP for an excellent learning opportunity.

[@khisalqureshi4654]

Amazing job as always Dr Gardner 🌟

[@toniasyrnioti9389]

Intro 0:00 Cutaneous clues for ischemia 6:06 (epidermal necrosis without any inflammatory changes) Necrosis of eccrine coil 8:42 Angioinvasive fungal infection 10:05 Thrombotic vasculopathy 21:38 Calciphylaxis 25:50 SJS/TEN 36:50 Staphylococcal skin scalded syndrome 47:38 Pyoderma gangrenosum 51:29

[@arunsood87]

Derm resident here. Thank you, this video was amazing. A very hypothetical teaching question - if biopsing ulcer and ddx includes PG, thromboembolic, vasculitis, infection - would I do a peripheral edge biopsy for H&E, biopsy the center for H&E, biopsy center for culture, and another biopsy for DIF? ie multiple biopsies?

[@JMGardnerMD]

Glad you liked it. Thanks! Unfortunately there’s no one perfect way and every case and scenario is a little different. For PG, the edge of the lesion to show undermining is the most important area in my opinion. For thromboembolic or calciphylaxis or infection, Middle of the ulcer is going to probably give you the highest yield. For vasculitis do not biopsy in or near the ulcer. Biopsy a violaceous area that is not ulcerated ideally. Because an ulcer can have secondary vasculitis that is related to the ulceration and may not actually be the primary reason for the ulcer. So even if I find vasculitis in an ulcer I usually put in the caveat in the report that it might not mean anything And I still recommend a dermatologist go back and biopsy of violaceous area that is not ulcerated. So to me a biopsy of an ulcer to rule out vasculitis is essentially useless unless the biopsy happens to find some other primary cause for the ulcer. As you probably have already figured out, biopsying ulcers is a frustrating business for everyone involved and often does not yield much useful information. But sometimes it does and that’s why we keep doing it

[@arunsood87]

Jerad Gardner, MD oh my gosh thank you so much for the response! I love your videos and your teaching !!

[@torresnicolas8599]

Great video! Thanks a lot. Can I ask you a question? In your opinion, witch are the best tips to differentiate calciphylaxis from other entities that also show calcification of vessels, such as: diabetes, atherosclerosis and ESRD (without calciphylaxis)? Or from dystrophic calcification? In addition to the clinical context.

[@tinocasadeitherezo6063]

Very interesting as always! How about coming to Brazil one of these days?

[@JMGardnerMD]

Thx! I spoke in Fortaleza in May 2019 and loved Brazil! I can’t wait to come back to visit again (And to have caipirinha and picanha!)

[@tinocasadeitherezo6063]

@@JMGardnerMD After the pandemics, you might as well repeat them (caipirinha and feijoada) here in São Paulo!!

[@thebeautycafewithdrnyorita]

🙏🏾⭐️