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VIDEO: Genetic tests, clinical data sharpen pigmented lesion diagnosis

WAIKOLOA, HAWAII – While many pigmented lesions analyzed in the dermatopathology lab are easily classifiable as benign or malignant, a certain percentage of cases are “very challenging to all examiners” – and in those cases, newer testing methods such as immunostaining or genetic testing can provide useful information, according to Dr. Whitney High.

Morphologic analysis of pigmented lesions under the microscope to determine whether a lesion is benign or malignant has limitations, said Dr. High, director of dermatopathology at the University of Colorado at Denver, Aurora. “We don’t really actually know. We haven’t genetically queried the cells.”

In a video interview at the Hawaii Dermatology Seminar, Dr. High emphasized, however, that no test is 100% sensitive and 100% specific. In fact, such tests should be considered adjunctive – requiring “some type of physician oversight or guidance to decide what is a significant result, what is an insignificant result, what is a confounded result, [and] what is a discrepant result.”

Clinical information is also useful, Dr. High said, noting that when this information is not provided, “I don’t really have any feeling from the clinician as to whether the lesion is new, growing, changing, [or] doing anything suspicious.”

The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company.

Dr. High had no disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

emechcatie@frontlinemedcom.com

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WAIKOLOA, HAWAII – While many pigmented lesions analyzed in the dermatopathology lab are easily classifiable as benign or malignant, a certain percentage of cases are “very challenging to all examiners” – and in those cases, newer testing methods such as immunostaining or genetic testing can provide useful information, according to Dr. Whitney High.

Morphologic analysis of pigmented lesions under the microscope to determine whether a lesion is benign or malignant has limitations, said Dr. High, director of dermatopathology at the University of Colorado at Denver, Aurora. “We don’t really actually know. We haven’t genetically queried the cells.”

In a video interview at the Hawaii Dermatology Seminar, Dr. High emphasized, however, that no test is 100% sensitive and 100% specific. In fact, such tests should be considered adjunctive – requiring “some type of physician oversight or guidance to decide what is a significant result, what is an insignificant result, what is a confounded result, [and] what is a discrepant result.”

Clinical information is also useful, Dr. High said, noting that when this information is not provided, “I don’t really have any feeling from the clinician as to whether the lesion is new, growing, changing, [or] doing anything suspicious.”

The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company.

Dr. High had no disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

emechcatie@frontlinemedcom.com

WAIKOLOA, HAWAII – While many pigmented lesions analyzed in the dermatopathology lab are easily classifiable as benign or malignant, a certain percentage of cases are “very challenging to all examiners” – and in those cases, newer testing methods such as immunostaining or genetic testing can provide useful information, according to Dr. Whitney High.

Morphologic analysis of pigmented lesions under the microscope to determine whether a lesion is benign or malignant has limitations, said Dr. High, director of dermatopathology at the University of Colorado at Denver, Aurora. “We don’t really actually know. We haven’t genetically queried the cells.”

In a video interview at the Hawaii Dermatology Seminar, Dr. High emphasized, however, that no test is 100% sensitive and 100% specific. In fact, such tests should be considered adjunctive – requiring “some type of physician oversight or guidance to decide what is a significant result, what is an insignificant result, what is a confounded result, [and] what is a discrepant result.”

Clinical information is also useful, Dr. High said, noting that when this information is not provided, “I don’t really have any feeling from the clinician as to whether the lesion is new, growing, changing, [or] doing anything suspicious.”

The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company.

Dr. High had no disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

emechcatie@frontlinemedcom.com

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