24. 1.- Dogmatic dermpath people are either really right or really wrong. 2.- “Consistent with””suggestive of” means tha pathologist is not sure! 3.- A biopsy cannot prove a rash is a drug reaction and cannot prove that it is not a drug reaction 4.- A biopsy cannot prove that a lesion is a bug bite or i not a bug bite. 5. Eosinophils usually are NOT present in lupus erythematosus. 6.- Eosinophils in vasculitis do not prove it is drug-related. 7.- Flame figures is not specific for Well´s syndrome. 8.- Nuclear dust does not mean vascilitis necessarily. 9.- Sweet syndrome –is it a vasculitis? 10.- Lymphocytic vasculitis and perivasculitis are nebolous. 11.- Erythema annulare centrifugum. The coat-sleeve infiltrate is overrated. 12.- The best special stain in dermpath is DEEPER LEVELS in the block. 13.- T and B-cell markers on rashes are usually not hepful. 14.- Gene rearrangements studies do not prove something is lymphoma. 15.- Langerhans microgranulomas in the epidermis are common witn contact dermatitis. PEARLS IN DERMPATH
25. 16.- If it is called junctonal dysplastic nevus, but is on severely sun damaged skin, it likely is a lentigo maligno. 17.- Almost all lentigos malignas arise de novo, NOT from a nevus. 18.- Dysplastic nevus grading is a mess. 19.- Follicular actinic keratosis- reason for liquid nitrogen failure. 20.- Keratoacanthomas usually are squamous cell carcinomas. 21.- Biopsy of white macules is usually a waste of time. 22.- Biopsy of subtle plaque: biopsy the edge with normal skin for comparison. 23.- Horizontal scalp biopsies might be likely to miss lupus erythematous. 24.- Culture, serology, or other tests are better tna biopsy for some diagnoses. 25.- Biopsy cannot prove something is congenital nevus. 26.- Leishmaniasis: NNN media for culture 27.- Dermatologist are qualified to read shin biopsies. 28.- Morgellon´s disease is a new name popular on intenet for patients with delusions of parasitosis 29.- Spindle-cell malignancies on sun damaged skin. The big 3 are atypical fibroxanthoma, spindel-cel melanoma and spindle-cell squamous cell carcinoma. 30.- Dermpath is to derm as EKGs are to cardiologists, and X-rays are to orthopedists.