Identifying Sweat Gland Tumors

Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.

In this episode of Digital Dermatology Digest, things are starting to heat up as dermatopathologist Rajni Mandal, MD, at PathologyWatch discusses sweat gland tumors.

What is a sweat gland tumor?

These skin tumors are often benign and derive from cells related to sweat glands. “Normal sweat glands have ducts and secretory components,” explains Dr. Mandal, noting the different appearance, which shows clear apocrine and eccrine cells.

Here are highlights of the four common types of sweat gland tumors.

  1. Hidradenoma papilliferum, which is common in the vulvar area. The distinct appearance of this dermal tumor includes papillary folds and the apocrine gland’s decapitation secretion.
  2. Papillary adenoma often appears in the axilla, the patient’s scalp, and other sites. This is a tumor of the skin, also known as eccrine papillary adenoma, where the tumor forms tubular and tubulopapillary structures.
  3. Apocrine hidrocystoma is common in the patient’s head and neck as well as the Moll’s gland in the eyelid. It’s a multiloculated cyst with apocrine cells and is often associated with Schöpf–Schulz–Passarge syndrome.
  4. Poroma is common on the patient’s palms, soles of their feet, and scalp. This benign adnexal neoplasm is composed of epithelial cells that show tubular (usually distal ductal) differentiation.

What is the treatment for sweat gland tumors?

Sweat gland tumors are often benign. However, some patients may prefer to have them removed surgically.

To learn more about this skin condition and other common diseases, join us for each episode of Digital Dermpath Digest right here on pathologywatch.com.

Don’t Miss the International Confocal Working Group’s 2nd World Congress on Confocal Microscopy on May 21–23 

Three days.

Three time zones.

One incredible experience.

That’s what we can expect from the International Confocal Working Group’s 2nd World Congress on Confocal Microscopy on May 21–23, 2021. 

This simulive interactive virtual event, sponsored by SUNY Downstate Departments of Pathology and Dermatology, will broadcast from Brisbane, Madrid, and Chicago.

We reached out to Nina McMurray, who, along with the Business Boutique team, is facilitating this virtual event. We wanted to learn more about in vivo and ex vivo laser scanning confocal microscopy and what we can expect from this year’s event. 

PathologyWatch: How are in vivo and ex vivo laser scanning confocal microscopy impacting the dermatopathology field?

Nina McMurray: In vivo reflectance confocal microscopy (RCM) is noninvasive dermatopathology. RCM and histopathology alike have their advantages and disadvantages. By embracing both, we can not only improve patient satisfaction by avoiding scars and pain associated with unnecessary biopsies, but we can also deliver safer, higher-quality care by ensuring biopsies are taken from the most diagnostically important area and minimizing false-negative results related to histopathology sampling errors.

Ex vivo laser scanning microscopy may revolutionize and could eventually replace frozen-section pathology. However, the greatest impact it could have on dermatopathology is enabling real-time invasive biopsy diagnosis, bypassing the need for tissue processing.

PW: Have you seen significant adoption of this technology in the medical fields?

NM: Confocal microscopy is still most widely adopted in Europe due to differences in reimbursement and healthcare delivery. However, since the recent development of specific CPT codes, adoption has grown in the US. It is disseminating as more US doctors and patients learn about the technology and more insurance plans begin covering the procedure.

We are proud to say that all active pioneers of this technology are faculty at this meeting. The combined experience of the presenters is unsurpassed. Furthermore, these key opinion leaders are also renowned for their complementary expertise in their fields of medicine. 

PW: What sets this upcoming May 21–23 event above other virtual events?

NM: This is a truly global event with 106 global experts from 22 countries, providing 113 lectures, and delivering 20 hours of CME-accredited points in three time zones. 

It is also the most comprehensive and inclusive meeting on this topic in history. Not only does this event provide the delegates with the highest level of the most up-to-date education on the current breakthroughs in the world of in vivo and ex vivo laser scanning confocal microscopy, but it is also delivered on an exciting interactive virtual site. This means you can speak directly with leading global experts or privately chat with colleagues from across the world in real time while sitting in the comfort of your own home.

You can raise your knowledge through high-quality education at an event that allows you to be safe and secure during the pandemic while simultaneously reducing your carbon footprint and minimizing your CME expenditure.

PW: How many people signed up for this event?

NM: Over 200 people have already registered. Pricing is set for accommodating so that we can reach as many of our students and fellows as well as our key physicians.

We have also set aside a pool of tickets for attendees with financial hardship. This event is barrier-free and inclusive. There is still time to book and spaces available, and no concerns about the impact of COVID, travel, or loss of earnings. We would love for you to join us!

PW: How has the response been since going virtual in 2021?

NM: There has been a buzz of excitement in the confocal community. The meeting had to be canceled last year due to the unprecedented effects of COVID-19. Melissa Gill and Orit Markowitz, the copresidents, were undeterred and have created this exciting platform to deliver the best of global experts. There is a real focus on the necessity of dermatology, pathology, and surgical specialists working together to ensure the safest forms of practice and best patient outcomes. The speakers and faculty are extremely excited to be a part of this meeting and deliver cutting-edge education to the broader community. This meeting is breaking boundaries educationally and in delivery alike. 

PW: What can attendees expect to experience during this event? 

NM: Although virtual, this platform is a significant step away from Zoom. The event will take place live across three different time zones, ensuring the delegates can interact with the speakers, ask questions, meet privately in the chat rooms to discuss current topics, visit the booths of their top manufacturers and companies in the exhibition hall, and visit the abstracts room to see what’s new in the world of confocal microscopy. 

In fact, it has been suggested that you will have better direct contact with these experts within this platform while also interacting with some of the key manufacturers and companies within a virtual exhibition. 

This interactive platform recreates the convention center experience but without the usual challenges of navigating the space. Moreover, direct access to global experts across multiple disciplines over three days sets this meeting apart from in-person and Zoom-style meetings. Certainly, everyone is ready to get together, share their knowledge, and deliver the most up-to-date trials and studies published. There will even be an interactive quiz and opportunities to win some very exciting prizes throughout the event.

PW: What can participants hope to take away from attending this event?

NM: To ensure active learning and development, we want our participants to enjoy the whole experience. We want our attendees to become part of our confocal microscopy community, enjoy sharing and learning from one another in a global setting, and have fun! Our mission is to grow the field of confocal microscopy through collaboration, inclusion, and education to improve patient safety and outcomes. 

Clinically, the key learning objectives are below:

  • Understand how in vivo and/or ex vivo confocal microscopy could be incorporated into the dermatologist, surgeon, or pathologist’s workflow to improve patient care
  • Identify the many applications of in vivo and ex vivo confocal microscopy
  • Improve diagnostic confidence and accuracy by incorporating recent advances in image acquisition and interpretation in addition to quality control steps when utilizing RCM for the diagnosis and management of a variety of skin diseases
  • Assess clinical endpoints while also evaluating potential complications and/or pitfalls when using confocal microscopy
  • Understand how machine learning techniques are being applied in the field of confocal microscopy

PathologyWatch will be there! Be sure to visit the PathologyWatch booth to discover what makes us the groundbreaking leader of digital dermatopathology services. Our friendly pathologists and representatives can answer your questions about our full-service dermpath lab and share the ways we can help you maintain optimal patient outcomes while reducing staff burdens.

For more information on the International Confocal Working Group’s 2nd World Congress on Confocal Microscopy on May 21–23, click here.

 

Darren Whittemore, DO, Featured in Orlando Medical News 

How does one slated to become an astronaut end up becoming a leading dermatopathologist? 

In a recent interview with Orlando Medical News, Darren Whittemore, DO, explains his roundabout journey to becoming a dermatopathologist and, ultimately, joining PathologyWatch. 

“The innovation emerging from this field has a global impact,” says Darren. “Technology has the power to bring together experts and students, breaking down barriers and extending our reach to smaller clinics in rural areas.”

Here are some highlights from that interview: 

OMN: Why did you choose a career in medicine?

Darren: While part of the aerospace engineering program as an undergraduate, I came to appreciate the completion of a project, which doesn’t always happen in the real engineering market. I was drawn to watching a project come full-circle. That’s what helped me decide to move toward a career in medicine. Those plans were confirmed when I got an Air Force scholarship for pathology at one of the biggest AF academic centers at the time.

OMN: What are you continuing to strive for in the world of dermatopathology?

Darren: I am fortunate to be surrounded by individuals who are committed to helping dermatology clinics deliver industry-leading care to their patients. That’s why I chose a career in dermatopathology: to make a difference.

To read the full interview with Darren Whittemore by Orlando Medical News, click here

 

PathologyWatch Boasts Key Addition to Its Roster of Dermatopathologists with Allison Readinger, MD

A leader in dermatology and dermatopathology, Allison Readinger, MD, joins PathologyWatch’s clinical team to assist in the growing landscape of digital healthcare.

Salt Lake City—March 7, 2021—PathologyWatch, a full-service digital pathology service, is pleased to welcome Allison Readinger, MD, to its clinical team. A highly qualified and respected dermatologist and dermatopathologist, Readinger brings a wealth of industry knowledge and innovation, coinciding with PathologyWatch’s mission to preserve and extend life for patients while reducing healthcare costs.

“We are pleased to have Dr. Readinger join us as a member of our clinical team. Her industry expertise and seasoned leadership skills make her a genuine asset,” said Dan Lambert, cofounder and chief executive officer of PathologyWatch. “Together, we are eager to expand our reach across the Texas market, positively impacting the lives of our healthcare providers and their patients.”

An alumnus of the University of Texas Medical Branch at Galveston, Readinger is a board-certified dermatologist and dermatopathologist with over 15 years of experience. In October 2010, she opened Trinity Vista Dermatology to offer more dermatology services to the rapidly growing population of Fort Worth, Texas.

Readinger recently served as President of the Texas Dermatological Society and continues to advocate for patients, for physician and resident education, and for her specialty.

At her core, Readinger enjoys bonding with her patients, providing excellent care, and being at the forefront of advances in medical technology. With an understanding of the importance of attention to detail and personalized care in modern medicine, she makes an excellent addition to the PathologyWatch family.

“I am thrilled to be a part of the continued growth of digital dermatopathology,” said Readinger. “The landscape of digital dermatopathology is growing at a rapid pace, and I am eager to assist in the continued growth and progress of our field.”  She adds, “I hope to utilize digital dermatopathology to expand further my ability to offer great clinicopathologic correlation to my clients.”

For more information, please email [email protected] or visit us at pathologywatch.com.

About PathologyWatch
PathologyWatch is the groundbreaking leader of digital dermatopathology services. Through these services, dermatology clinics, hospitals and laboratories can improve operational efficiency by speeding up workflow and enhancing patient outcomes by utilizing the PathologyWatch expert professional team and partner laboratory services. This can facilitate best-in-class reads and, in some cases, enable additional revenue to the practice by in-housing pathology. With an intuitive and easy-to-implement digital pathology solution that includes access to top-tier dermatopathologists and a streamlined clinical workflow that interfaces directly into the EMR, PathologyWatch brilliantly combines state-of-the-art technology and clinical decision-making to deliver unprecedented patient care.

3 Ways Locum Tenens Can Help Expand Your Pathology Lab

If you are exploring new ways to expand your pathology lab with additional services or you see a need to bolster your team to keep up with growing demands, hiring full-time pathologists may feel a little too risky. Rather than putting off your plans, have you considered locum tenens with on-demand dermatopathologists? 

A recent survey found that 69 percent of healthcare facility managers said they use at least one locum tenens provider in a typical month, while 19 percent said they use seven or more. They recognize the benefits that locum tenens provides, including consistent revenue, flexibility in patient care, and expanding access to patient care. Let’s discuss how each point may benefit you.

1. Protects Revenue Flow

How can you keep your lab running when your primary revenue generators need time off? Schedule a locum tenens dermatopathologist to cover for them. That means you can bill for services even when your primary providers are not available.  If we don’t have a physician working, that means we don’t have a nurse working, and it goes all the way down through the organization. So the locum physicians are an integral part of how we provide care,” says Kelly Cameron, a director of provider recruitment and retention.

Similarly, if a lab is short-handed on dermatopathologists, profits may be lost as clinics will be forced to send their work elsewhere to ensure appropriate turnaround times.  At PathologyWatch, our locum tenens dermatopathologists work remotely to easily transition between labs by using digital pathology tools that streamline tasks and create a more efficient and cost-saving process for you. That means you save on expenses for travel, housing, and per diems. Plus, our EMR interface provides quick access to results, patient information, health services partners, etc. Should you opt for virtual locum services, we offer secure, 24/7 access to your pathology slides.

2. Provides Flexibility in Patient Care 

An important step in patient care innovation is to provide specialized services your patients want and need. But it can be risky to explore new care models by hiring permanent staff. Our staff of board-certified, academic-level dermatopathologists provide expertise in the areas you may be considering in your clinic.  Do you want to specialize in rare skin diseases that are prevalent in your area? Test that service with a locum tenens dermatopathologist. If it’s successful, a locum tenens doctor can remain in place until a permanent position is filled. 

3. Expands Access to Patient Care

We’ve encountered at least two ways that locum tenens dermatopathologists can help your practice reach more patients. These include treating patients in rural or seasonally-impacted areas and using teledermatology for those who have difficulty visiting a doctor in person.  Many healthcare networks have opened up clinics in rural areas where fluctuations in seasonal work or outdoor recreation impact the volume and type of care patients need most.

For instance, a clinic located by heavy agricultural operations or popular recreation areas where people spend more time outdoors during the busy warmer months of the year will experience an influx of patients but may not need a full staff all year long. Locum tenens doctors are prepared to go where patient care is needed most. And when the busy season ends, it’s easy to reduce the staff size. 

As one of the most rapidly expanding branches of telemedicine, teledermatology is another way to utilize dermatopathology expertise and provide care for patients in remote locations. “Dermatology is particularly suitable for telemedical diagnosis and consultation due to its image‐based orientation in diagnostics,” says Peter Elsner. Since the COVID-19 onset, experts estimate at least half of all dermatologists practicing in the US use telehealth technology. 

If you are one of the 85 percent of healthcare facility managers who used locum tenens services within the past 12 months, you’ve likely benefited from the forward-thinking strategies many locum tenens used to bolster your practice. With PathologyWatch locum tenens dermatopathologists, your lab can maintain revenue while balancing the needs of your valued staff, use expertise to explore new care models, and utilize innovative digital technologies to create more efficient patient care processes. Although locum tenens services may be temporary, the proven solutions, expertise, and technology will remain.

For more information about our locum tenens services, email us at i[email protected].

Identifying Trichoepithelioma

Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.

At first glance, these individual lesions may look like basal cell carcinoma, but don’t be confused: Trichoepithelioma appears as firm, rounded, and shiny tumors that originate in the hair follicle. 

In this episode of Digital Dermpath Digest, Rajni Mandal, MD, a dermatopathologist at PathologyWatch, discusses distinct features of trichoepithelioma and how to identify them.

What Is Trichoepithelioma?

The distinct rounded and shiny appearance of this rare benign skin lesion occurs primarily on the cheeks, on the eyelids, and around the nose, yet it can spread to arms and stomach. They typically increase in number as the patient ages and presents as papillary-mesenchymal bodies, granulomas, and signs of calcification. 

“There are three clinical types of trichoepithelioma,” says Mandal, “Solitary, multiple, and desmoplastic.”

  • Solitary trichoepithelioma: This variant is characterized by a single firm dermal papule or nodule that often appears on the face.
  • Multiple trichoepitheliomas: Often called Brooke-Spiegler Syndrome, it’s composed of familial cylindromatosis and multiple familial trichoepitheliomas variants. 
  • Desmoplastic trichoepithelioma: Characterized by a prominent, sclerotic stroma, the most common features of this variant include asymptomatic, solitary, ring-shaped, centrally depressed papules. When viewed as a digital slide, this variant has tadpole-shaped islands, fibrous stroma, and calcifications. They can appear anywhere but are more commonly found on the upper cheek. 

What Are the Most Common Treatments?

Dermatologists can surgically remove individual lesions, particularly if there are risks of malignancy. Other treatment options include carbon dioxide laser and dermabrasion, which may improve the skin’s appearance, but there is a slight possibility of regrowth. 

To learn more about this skin condition and other common diseases, join us for each episode of Digital Dermpath Digest right here on pathologywatch.com.