Skin cancer, sunscreens, and prevention: discussions to have with patients.

With the incidence of skin cancer increasing in the United States, the role of dental providers in noting suspicious skin lesions as well as advising patients in proper sun-protective strategies is more important than ever. However, the public conversation about proper sun protection is often laden with misunderstandings and pervasive myths. This article reviews the most common types of skin cancer, elucidates the differences among the types of UV radiation, and offers updated recommendations for proper sunscreen use along with adjunctive sun-protective strategies.

VSGD-Net: Virtual Staining Guided Melanocyte Detection on Histopathological Images.

Detection of melanocytes serves as a critical prerequisite in assessing melanocytic growth patterns when diagnosing melanoma and its precursor lesions on skin biopsy specimens. However, this detection is challenging due to the visual similarity of melanocytes to other cells in routine Hematoxylin and Eosin (H&E) stained images, leading to the failure of current nuclei detection methods. Stains such as Sox10 can mark melanocytes, but they require an additional step and expense and thus are not regularly used in clinical practice.

An analysis of pathologists' viewing processes as they diagnose whole slide digital images.

Although pathologists have their own viewing habits while diagnosing, viewing behaviors leading to the most accurate diagnoses are under-investigated. Digital whole slide imaging has enabled investigators to analyze pathologists' visual interpretation of histopathological features using mouse and viewport tracking techniques. In this study, we provide definitions for basic viewing behavior variables and investigate the association of pathologists' characteristics and viewing behaviors, and how they relate to diagnostic accuracy when interpreting whole slide images.

Improving the Diagnosis of Skin Biopsies Using Tissue Segmentation.

Invasive melanoma, a common type of skin cancer, is considered one of the deadliest. Pathologists routinely evaluate melanocytic lesions to determine the amount of atypia, and if the lesion represents an invasive melanoma, its stage. However, due to the complicated nature of these assessments, inter- and intra-observer variability among pathologists in their interpretation are very common.

Segmenting Skin Biopsy Images with Coarse and Sparse Annotations using U-Net.

The number of melanoma diagnoses has increased dramatically over the past three decades, outpacing almost all other cancers. Nearly 1 in 4 skin biopsies is of melanocytic lesions, highlighting the clinical and public health importance of correct diagnosis. Deep learning image analysis methods may improve and complement current diagnostic and prognostic capabilities.

Scale-Aware Transformers for Diagnosing Melanocytic Lesions.

Diagnosing melanocytic lesions is one of the most challenging areas of pathology with extensive intra- and inter-observer variability. The gold standard for a diagnosis of invasive melanoma is the examination of histopathological whole slide skin biopsy images by an experienced dermatopathologist. Digitized whole slide images offer novel opportunities for computer programs to improve the diagnostic performance of pathologists.

Implementation and Effectiveness of a Completely Virtual Pathology Rotation for Visiting Medical Students.

Objectives: Coronavirus disease 2019 (COVID-19) upended in-person medical education, relocating many activities online. We designed a completely virtual pathology rotation to replace our traditional visiting rotation.

Methods: The virtual away rotation was listed in the Visiting Student Application Service (VSAS) and advertised on social media as well as various medical student mailing lists.

Characterization of multiple diagnostic terms in melanocytic skin lesion pathology reports.

Background: Histopathologically ambiguous melanocytic lesions lead some pathologists to list multiple diagnostic considerations in the pathology report. The frequency and circumstance of multiple diagnostic considerations remain poorly characterized.

Methods: Two hundred and forty skin biopsy samples were interpreted by 187 pathologists (8976 independent diagnoses) and classified according to a diagnostic/treatment stratification (MPATH-Dx).

Medical Education in Pathology: General Concepts and Strategies for Implementation.

Context.—: Pathology education must evolve as medical knowledge expands and disruptive technologies emerge. The evolution in pathology teaching practices accelerated as traditional teaching modalities were suspended in March 2020 during the coronavirus disease 2019 (COVID-19) pandemic.

Impact of clinical photographs on the accuracy and confidence in the histopathological diagnosis of mycosis fungoides.

Background: The histopathological diagnosis of MF is challenging, and there is significant overlap with benign inflammatory processes. Clinical features may be relevant in the assessment of skin biopsies.

Methods: We provided photomicrographs to board-certified dermatopathologists and one hematopathologist with and without accompanying clinical photographs and assessed accuracy and confidence in diagnosing MF.

Remote Anatomic Pathology Medical Student Education in Washington State.

Objectives: The coronavirus disease 2019 pandemic has halted in-person medical student education in many large academic centers, including the University of Washington. We identified a unique opportunity to bring comprehensive and targeted anatomic pathology training to large numbers of medical students who would not receive it otherwise but also need credited coursework.

Methods: We developed a comprehensive 2-week remote-learning course encompassing lectures, virtual slides, discussion groups, and unique case-based activities.

A 68-Year-Old Man With Skin Rash and a Pleural Effusion.

A 68-year-old man developed an erythematous, papular, pruritic rash on his right thigh 1 month prior to presentation. It subsequently spread to his other extremities and trunk. He also endorsed fevers of > 38.

Metastatic renal cell carcinoma to the mandible: a case report with clinical and histologic findings.

Metastatic disease to the oral cavity is rare. Patients with metastasis to the oral cavity may present with swelling, pain, and paresthesia and require evaluation by providers trained in managing pathoses of the oral cavity and surrounding structures. This report describes the case of a 78-year-old man with painful enlargement of the right posterior mandible that caused paresthesia.

Should Margin Status of Biopsies Be Included in Dermatopathology Reports? Clinician Preferences and the Importance of Unambiguous Language.

Significant communication occurs between pathologists and clinicians through the dermatopathology report. Our objective was to describe clinician preference about reporting of the margin status of skin biopsies of nonmelanoma skin cancers. An anonymous survey was sent to 243 medical providers who submitted specimens to a single institution university medical center; 50 complete responses from attending-level providers and advance practice providers were received.

Detailed Speciation of Intermediate Volatility and Semivolatile Organic Compound Emissions from Gasoline Vehicles: Effects of Cold-Starts and Implications for Secondary Organic Aerosol Formation.

Over the past two decades vehicle emission standards in the United States have been dramatically tightened with the goal of reducing urban air pollution. Secondary organic aerosol (SOA) is the dominant contributor to urban organic aerosol. Experiments were conducted at the California Air Resources Board Haagen-Smit Laboratory to characterize exhaust organics from 20 gasoline vehicles recruited from the California in-use fleet.

Triamcinolone Acetonide-Assisted Descemetectomy for Retained Descemet Membrane.

We present a case of decreased vision due to the presence of retained Descemet membrane (DM) following Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP). A 78-year-old male presented postoperatively from PKP after previous failed DSAEK with retained DM. We present a unique technique for combined surgical resection using bimanual vitrectomy and forceps excision assisted by triamcinolone acetonide for membrane visualization.

A giant apocrine hidrocystoma of the trunk.

Hidrocystomas are benign cysts that typically present as translucent, bluish dermal nodules on the face and are rarely > 1 cm in size. They are classically categorized as eccrine or apocrine based on histologic features. We present a rare case of a giant apocrine hidrocystoma of the trunk, demonstrating that, although a rare variant, apocrine hidrocystomas can present both off the head and neck, and can be significantly larger in size than previously reported.

Comparison of Proliferation Markers Ki67 and Phosphohistone-H3 (pHH3) in Breast Ductal Carcinoma In Situ.

Proliferative index is a prognostic feature of invasive ductal carcinoma of the breast, and has more recently emerged as a predictor of ductal carcinoma in situ (DCIS) local recurrence and progression when used in combination with other predictive markers. Ki67 is the most commonly used immunohistochemical marker of proliferative index. However, high interobserver and interlaboratory variability has been reported, in part due to differences in staining methodologies, positivity thresholds, and approaches to quantification.

Polyomavirus-Negative Merkel Cell Carcinoma: A More Aggressive Subtype Based on Analysis of 282 Cases Using Multimodal Tumor Virus Detection.

Previous studies have reached conflicting conclusions regarding the proportion of Merkel cell carcinomas (MCCs) that contain the Merkel cell polyomavirus (MCPyV) and the clinical significance of tumor viral status. To address these controversies, we detected MCPyV large T antigen using immunohistochemistry with two distinct antibodies and MCPyV DNA using quantitative PCR. Tumors were called MCPyV-positive if two or more of these three assays indicated presence of this virus.

Loss of Conventional Melanocytic Markers in Malignant Melanoma and Lymph Node Metastasis; an Uncommon but Dangerous Pitfall.

Although malignant melanomas exhibit a wide range of immunophenotypes, concurrent loss of all 3 conventional melanocytic markers (S-100, Melan-A, and HMB-45) is relatively rare. We report a case of primary malignant melanoma with lymph node metastasis, both exhibiting loss of immunoreactivity for conventional melanocytic markers, while aberrantly expressing epithelial antigenicity (pancytokeratin, CAM 5.2).

Centrofacial Balamuthiasis: case report of a rare cutaneous amebic infection.

Free-living amebae are ubiquitous in our environment, but rarely cause cutaneous infection. Balamuthia mandrillaris has a predilection for infecting skin of the central face. Infection may be restricted to the skin or associated with life-threatening central nervous system (CNS) involvement.