A detailed understanding of skin morphology should not be reserved for dermatologists or pathologists alone. It is essential for those who:
- Perform gross examinations of skin specimens (skin orientation critical)
- Embed the skin tissue into paraffin (skin orientation critical)
- Cut frozen sections of skin or perform Mohs cryosections (skin orientation critical)
- Section paraffin-embedded skin tissue (skin orientation critical)
- Perform special staining techniques on skin tissue slides
Most of the work involved in skin sample manipulation is gross and can be discerned with the naked eye since the skin has distinct layers and textures. Inarguably, skin orientation must be maintained throughout the entire process. A good representation of the complete cross-section of a skin sample is what is typically desired. The epidermis must be located to section the specimen correctly during gross examination. During embedding, skin biopsies are usually embedded on the edge to reveal a complete cross-section and all layers of the skin. If the epidermis is embedded face down, it will be the first layer to be cut away during microtomy, and the diagnosis will be cut away with it. The microtomist should also be able to detect and correct a skin section that has been poorly embedded in the paraffin block. Faulty orientation at any point can lead to the wrong diagnosis and can result in poor quality patient care.
Also, histotechnologists who perform special stains should be able to decipher the special stains on skin slides. A thorough knowledge of skin morphology and how skin cells stain will bring confidence in discerning how well a special stain works.
