The Histology of Dermatological Specimens - Part 2 (Online CE Course)

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Author: Diana Harrington, BS, HT(ASCP)
Reviewer: Carla Shoffeitt, MSM, HT(ASCP)

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This course, the second in the dermatological specimens series, addresses the most common concerns of working with dermatology specimens and provides tips to create high quality slides for the dermatopathologist. Explored topics include optimal processing, sectioning, and recut protocols for skin biopsies, shaves, and excisions. The histomorphology of skin is reviewed and commonly used H&E and special stains are discussed. Possible sources of problems are also investigated and solutions are applied to prevent artifacts on skin sample slides.

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Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 1 hour(s)
Approved through 9/30/2023
Approved through 9/1/2022

Objectives

  • Describe the optimal processing protocol for skin biopsies and fatty skin excisions, including how fat content and tissue size affect processing.
  • Explain why accurate embedding of skin samples is critical to diagnosis and describe the best way to embed skin to obtain high quality slides.
  • Describe the most common sectioning and recutting protocols for shaves, punches, and excisions.
  • Identify sectioning artifacts, their possible sources, and solutions.
  • Identity the skin layers and cells of a properly stained hematoxylin and eosin (H&E) slide.
  • Identify the most commonly used special stains for skin specimens and the cells and structures they highlight.

Customer Ratings

(based on 5 customer ratings)

Course Outline

Click on the links below to preview selected pages from this course.
  • Introduction to Skin Histology
      • Introduction to Skin Histology
  • Review of Skin Histomorphology
      • The Importance of Understanding Skin Morphology
      • Overview of Skin Layers
      • Distinguishing between skin layers is an essential part of embedding, sectioning, and staining skin tissue.
      • Place the three layers of skin in order, beginning with the outer layer.
  • Skin Sample Identification
      • Identifying Skin Sample Types
      • Which of the choices best describes a skin sample that has a characteristic cone shape that reveals all skin layers?
  • Skin Paraffin Processing
  • Skin Embedding Techniques
      • Embedding Skin Tissue
      • General Embedding Considerations
      • Melted paraffin for embedding purposes should be maintained at 10-15º C above the melting point of the paraffin being used.
      • Skin Embedding Techniques
      • Skin excisions are embedded with the cut surface DOWN and gently pressed, edge to edge, so the tissue surface lays flat in one plane.
  • Skin Sectioning Techniques
      • Sectioning Skin Tissue
      • Skin Sectioning Techniques
      • Sectioning one block at a time and floating only one block's ribbon(s) on the water bath prevents the tech from accidentally placing one patient's tis...
      • Skin Sectioning Protocols
      • Skin Sectioning Artifacts
      • Skin Sectioning Troubleshooting
      • A histologist is reviewing the stained slides. She notices that several of the slides have tissue fragments and incomplete sections of skin. What is/a...
  • Skin Staining - H&E and Special Stains
  • Conclusion to Skin Histology
      • Conclusion
  • References
      • References

Additional Information

Level of instruction: Basic 
 
Intended audience:  Clinical laboratory histotechnologists, histotechnicians, and other medical laboratory personnel who have an interest in this subject matter. This course is also appropriate for histology and clinical laboratory science students, pathology residents, and practicing pathologists.  
 
Author information: Diana Harrington, BS, HT(ASCP) is a histotechnologist at The Dermatology Center of Indiana. Since graduating from Indiana University, she has worked in various hospital laboratories as a medical technologist and histotechnologist. Her experience led her to teach IU students as a Clinical Education Supervisor and create the Histotechnology Program as Program Director for Keiser University in Florida.
 
Reviewer information: Carla J. Shoffeitt, MSM, HT(ASCP) is the Manager of the Pathology Department of Emory St. Joseph’s Hospital of Emory Healthcare in Atlanta, Georgia. She holds a Master of Science Degree in Healthcare Management as well as a Bachelor of Science degree in Biology from Troy University, Troy, Alabama. She is certified as a Histotechnician and has 25 years of experience in the field of Histology.
 
Course description: This course, the second in the dermatological specimens series, addresses the most common concerns of working with dermatology specimens and provides tips to create high quality slides for the dermatopathologist. Explored topics include optimal processing, sectioning, and recut protocols for skin biopsies, shaves, and excisions. The histomorphology of skin is reviewed and commonly used H&E and special stains are discussed. Possible sources of problems are also investigated and solutions are applied to prevent artifacts on skin sample slides.

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Complete skin sections


Elastic stain. Elastic fibers black.


Folds/ tears in tissue


GMS silver fungus black


Grocott's methenamine silver (GMS)


Incomplete and complete skin sections


Mesh Biopsy Cassette


Ribbons from two different blocks on one water bath should be avoided to prevent placing the wrong tissue on the slide.