Skin chapter
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Microscopic evaluation
If the referral does not point to any particular request (see "Most common requests" above), the following algorithm may be applied:
- Is it a suspected malignant skin excision? If not:
- If primarily inflammatory, evaluate as dermatitis. If none of these, evaluate as:
- Benign non-inflammatory skin conditions, including skin cysts
In intraoperative consultations by frozen section, it is generally sufficient to report clear margins if present, and specification of the type of tumor can be deferred to permanent sections.
Reporting
Preferably see specific articles from algorithm in section above.
- Optionally, the presence of a keratinized squamous epithelium.
- Any abnormalities, generally preceded by location in terms of epidermal, dermal or more specific layers thereof.
- If malignant:
- Degree of differentiation
- Radicality/Least distance to a margin
- Perineural or vascular invasion if present