Rooky Tuesday! 🔬 Warty dyskeratoma 😎🫡💪 🥣 Cup-shaped, keratin-filled follicular invagination ✂️ Suprabasal acantholysis with villi 🎯 Dyskeratosis: corps ronds & grains 🔍 Differentials • Acantholytic dyskeratotic acanthoma: lacks follicular cup • Darier/Grover disease: clinical distribution • Acantholytic SCC: atypia & invasion #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

Join! #cap26 #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter #BSTpath @Pathologists @MGBpathology

24-year-old man with a wrist lesion, being evaluated for Mohs 🙂 Blue nevus–type melanocytoma is currently divorcing itself from PEM on molecular grounds: 🧩 Biphasic: dendritic blue nevus + cellular ovoid/spindle component 🧬 GNAQ/GNA11 pathway #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

🔬 Interested in dermpath? This is the path forward! 🎓 ASDP Mentorship Award: Two weeks with any ASDP full-member mentor (not just the list provided 👇🙃; funding up to $3,000. 📅 Apply Oct 15 to Dec 15 👉asdp.org/ASDP/ASDPWeb/Physic… #dermpath #ASDP26 #PathTwitter #DermTwitter #pathresidents #FutureDermpath #Mentorship @ASDPTweets @TheUSCAP @Pathologists @ColumbiaDerm

I would say it’s useful, works even for crtical diagnostically challenging cases with good sensitivity unless it’s borderline expression or it’s discordant clinicopathologic presentation. But if it doesn’t work for you, then you absolutely shouldn’t be using the stain :)

Always, excellent and so very very posh!

Amazing !

🔬TRBC1 clonal pattern — outscope your mentor! 1.Read the article 👇 Free download for 50 days. 2.Spot the clone first 👀 3.Realize your preceptor is mortal! 4.Graduate& 🎓 Move on 😄If I could do it, so can you! sciencedirect.com/science/ar… #CTCL #pathologists #pathTwitter #dermpath #dermatology #dermtwitter #pathology @ModernPathology @TheUSCAP @MassGenBrigham

❤️ 💕 💗 #dermatology #dermpath #pathtwitter #dermtwitter

Part II: 🔥📷 Hello, Dermpath world! Would you buy these as flame figures? 📷#pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

🔥🔬 Hello, Dermpath world! Would you buy these as flame figures? 👀 #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

🔬 Granular cell tumor — high-yield pearls 📍 Clinical • Solitary, slow-growing, firm nodule • Head/neck common, especially tongue 👅 • Usually benign; malignant tumors are rare 🧫 Histology • Poorly circumscribed, infiltrative dermal/subcutaneous neoplasm • Large polygonal cells with abundant coarse eosinophilic granular cytoplasm • 🔥 Granules = numerous intracytoplasmic lysosomes/autophagolysosomes • PASD+, diastase-resistant granules (do you know anybody who does it?) • Cells dissect between collagen bundles and may involve nerves or skeletal muscle • Overlying pseudoepitheliomatous hyperplasia may mimic SCC ⚠️ 🧬 IHC • Conventional granular cell tumor = Schwannian, S100+/SOX10+ • Non-neural granular cell tumor = non-Schwannian, S100−/SOX10− #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

I think the full-article pre-proof is available for all the CTCL adorers! This is the first article in Dr. Gru’s series on real-world experiences. Stay tuned!🔬👇sciencedirect.com/science/ar… #CTCL #Lymphoma #Dermatology #Dermatopathology #TRBC1 @alegru18 @MPulitzerMD @TorresCabalaMD

CD30 has nothing to do with LCT! Nice case 🚨🫡

🟡 Verruciform xanthoma 👀 Often looks like a wart clinically: solitary, slow-growing, verrucous/papillomatous plaque or nodule, classically oral or anogenital. 🔬 Histo: verrucous/psoriasiform hyperplasia + hyperparakeratosis ± neutrophils. 🫧 Don’t miss the clue: foamy macrophages packed superficially in the papillary dermis between rete ridges. 💡 Wart-like lesion + superficial foam cells → think verruciform xanthoma. #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter

Hi Nea, thank you for this note. Yes , I would say that’s Columbia’s living real world life experience.

So yeah, I did think it was pretty clearly PS or PRP. However, inflammatory patterns are in the eyes of the beholders and there is always some sponge around the corner :-)

Going into derm? This one’s for you! 👇 Skip it if you’re just derm-curious or a total beginner 🙂 🔬 Histo: Psoriasiform dermatitis (see below). 👀 Clinical: they really want eczema! 🧠 Beyond morphology: Can we really see everything on H&E? How many stains/ancillary are enough? There is always some sponge around the corner! 🧬 Cytokine ISH : NOS2 and IL17 were positive, supporting psoriasis and consistent with the histopathology. IL13 and IFNG were negative (attached table for expression patterns). 🔬 Histo is king—but not the whole kingdom anymore! #pathology #pathologists #pathTwitter #dermpath #dermatology #dermtwitter