title: Hematoxylin and eosin tissue stain in Mohs micrographic surgery: a review.
abstract: BACKGROUND
  Several factors may affect Mohs micrographic surgery (MMS) tissue section quality. Although other factors may affect section integrity and ease of processing, tissue stains are the cornerstone of histologic diagnosis. When performed incorrectly, visualization and discrimination of microscopic details may be suboptimal and even impossible. Patient harm may result if an accurate diagnosis cannot be made.
  
  
  OBJECTIVE
  To review hematoxylin and eosin (H&E) technique, the most commonly used staining technique in MMS tissue preparation.
  
  
  METHODS
  Review of literature. Tissue sections were H&E stained using a linear stainer where one reagent container was omitted on each trial run to evaluate microscopic differences in staining quality.
  
  
  RESULTS
  The chemical nature of H&E staining is discussed, along with commonly encountered problems, pitfalls, and troubleshooting tips. H&E stained sections are presented to demonstrate histologic appearance in the absence of certain reagents.
  
  
  CONCLUSIONS
  The success of MMS depends on high-quality tissue sections. The staining process should be optimized to be reproducible and reliable. To readily identify and resolve poor staining quality, a firm understanding of the principles upon which tissue staining is based and its pitfalls is necessary.
authors.affiliation: Department of Dermatology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA.
authors.forename: Kassandra
authors.initials: K
authors.lastname: Larson
authors.forename: Hao H
authors.initials: HH
authors.lastname: Ho
authors.forename: Pushpa L
authors.initials: PL
authors.lastname: Anumolu
authors.forename: T Minsue
authors.initials: TM
authors.lastname: Chen
mesh_terms: D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin; D006801:Humans; D015580:Mohs Surgery; D011786:Quality Control; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin