Squamous cell carcinoma under the microscope (pathology dermpath dermatology dermatopathology)

[@Familylawgroup]

Lay patient here ….in looking at the episode round and it’s flaking, would this have the external physical appearance of ichthyosis type flakes? As a lay person, when I read medical journal articles of interest to me, I often see pictures of the skin lesion, then a dermoscopy picture of the lesion, magnified, and then pictures of histology slides. I keep trying to figure out if a biopsy was taken as a shave biopsy or a punch biopsy? Is there an easy way to determine, for a non-doctor, whether the histology stain is showing a slice, top down, but spread sideways on the slide and, if so is that more likely to be a shave biopsy that is examined or do you take the punch biopsy sample, freeze it, and make super thin slices from the top down? Also, I have a basic grasp of the use of stains from watching you channel but I am curious how many stains are frequently used in derm pathology? Who applies the stain to the sample> is it done by the clinician or is it done by the path lab? If a derm send you a sample seeking to rule out malignancy and you are able to do that with a particular set of stains, is there usually enough sample left for you to run other stains or to take the time to identify a particular condition that might not even be mentioned? I am curious where you start if a derm asks for help in diagnosing the lesion, do you only see the biopsy or do you get access to the rest of the images the clinician has on file? This may seem like a silly line of questions but I have a childhood memory which makes me ask. When I was about 8 or 9 years old, my mom was part of a voluntary student about osteopoikilosis. During her exam, they found a skin lesion on her stomach which they biopsies. While they were fairly certain it was not cancer, the link of her spotted bone disease and various collegenomas or elastomers wasn’t as well known. (This was in the mid 1970s). They determined that her lesion was dermatofibrosis lenticularis and when that skin lesion is combined with her spotted bones - she had a syndrome called Buschke-Ollendorff Syndrome, At that same time, the doctors started taking preliminary X-rays in me and I had more spotted bones than my mom, even at 7. I had already found my weird skin spot, in my upper thigh, many years prior. I have ever had it biopsies but it is clear to all that it is the same as what my mom had on her stomach. About 10 years ago, I made contact with a biological half-sister who had been placed for adoption. She doesn’t know if she has spotted bones but she absolutely has the skin lesions in her wrists and she and her PCPs were never quite sure what it was. Since it wasn’t growing or changing, they hadn’t biopsies that lesion. However, my knowledge of BOS, aided dramatically by the research study in which my mom participated, paved the way for that reassurance. I bring this us because that was before DNA and before a clearly established link between the two conditions. If a sample such as that had come into the path lab and you were asked to identify it, where would start after ruling out malignancies? Am I correct inoresuming that the top priority is to rule it any conditions requiring life saving intervention.