Dermatopathology Rotation (AP-2)
- Dr. Rossitza Lazova and Faculty
Residents are exposed to dermatopathology specimens from two different sources. Specimens resulting from surgery in the YNHH operating rooms come to surgical pathology. This consists mostly of resections of cutaneous malignancies with some additional biopsies mixed in. In addition, residents rotate through the Yale Dermatopathology Laboratory within the Department of Dermatology, where approximately 70,000 specimens per year are interpreted.
Residents' responsibilities include participating in the daily sign-out of dermatopathology specimens, as well as researching interesting cases, gathering cases for teaching purposes, and preparing and presenting occasional talks. In addition, residents are also expected to review teaching sets with examples of different neoplastic and inflammatory conditions.
During a typical morning, the resident handles specimens received in Pathology, and signs out with a dermatopathology faculty member each day. Many cases may be signed out with other Pathology faculty. In the afternoon, the resident reviews and attends signout of cases in Dermatopathology.
The didactic teaching program in Dermatopathology for the dermatology residents consists of a weekly conference, which throughout the academic year covers major topics in dermatopathology. A small number of these conferences are mandatory for pathology residents. However, all of these conferences are open to the pathology residents. Pathology residents should attend these conferences while on Dermatopathology rotation. Reading material is assigned prior to the conference and residents are encouraged to review the slides and be prepared to discuss them during conference. These didactic sessions are conducted largely by Yale's board-certified dermatopathologists, one Yale-affiliated board-certified dermatopathologist from the community, and the dermatopathology fellow. There is also once or twice a month slide review and teaching conducted by the dermpath fellow with review of a variety of interesting cases collected during the preceding month. Additional lectures in Dermatopathology are given throughout the year on a variety of topics in skin pathology, specifically for the pathology residents. Residents also have the opportunity to review two large study sets, often with the guidance of a dermatopathologist or the dermpath fellow.
Additional Resident Duties and Responsibilities
- Attend Dermatology Grand Rounds
- Attend all of the weekly dermatopathology conferences
Additional Goals and Objectives for the Dermatopathology Rotation
- Mastering skills needed to correctly orient and gross skin specimens:
- Proper fixation and dissection
- Appropriate usage of cassettes and an understanding of tissue processing
- Ability to know limitations, seek help from the fellow or attending prior to grossing
- Expected fund of knowledge:
- Inflammatory conditions
- Know criteria for psoriasis and eczematous dermatitides
- Know criteria for Graft vs Host disease and differential diagnosis with drug eruption and erythema multiforme
- Know histologic features for Lupus erythematosus and Dermatomyositis
- Know how to differentiate toxic epidermal necrolysis from staph scalded skin syndrome on frozen and permanent sections
- Recognize common inflammatory patterns of cutaneous infection on routine and specially stained sections
- Neoplastic conditions: Know the characteristic histologic features of...
- melanocytic nevi and malignant melanoma
- basal cell carcinoma and distinction from benign tumors of the hair follicle
- squamous cell carcinoma, and distinction from pseudoepitheliomatous hyperplasia
- common benign conditions such as epidermoid cysts, hemangiomas, acrochordons and dermatofibromas
- Inflammatory conditions