title: Novel Use of Preoperative Epidermal Coloring of Very Small Dermatological Specimens-Protocol for Reduction of Lost Specimens.
abstract: Small tissue biopsies are often difficult to visualize and can be easily lost or mishandled. The authors hypothesized that full epidermal surface coloration of small skin lesions with a sterile skin marker (gentian violet ink) before performing shave biopsy would make small gross specimens easier to identify without impacting microscopic appearance. Live evaluation of 4 inked and 4 noninked gross (2-3 mm) specimens in covered and uncovered formalin-containing jars by 50 consecutive health care personnel demonstrated that inked specimens were significantly (P < 0.001) easier to visualize than noninked specimens. Additionally, a blinded dermatopathologist evaluated 25 inked and 25 noninked specimens microscopically. Utilization of this inking process did not interfere with histopathologic assessment or impede diagnosis. This pilot study describes an easily implementable quality improvement measure that may decrease the rate of loss and mishandling of specimens.
authors.affiliation: Division of Dermatology, Loyola University Medical Center, Maywood, Ill., USA.
authors.forename: David
authors.initials: D
authors.lastname: Surprenant
authors.forename: George
authors.initials: G
authors.lastname: Garib
authors.forename: Kelli
authors.initials: K
authors.lastname: Hutchens
authors.forename: Michael
authors.initials: M
authors.lastname: Dreifke
authors.forename: Jodi
authors.initials: J
authors.lastname: Speiser
authors.forename: Laura
authors.initials: L
authors.lastname: Winterfield
authors.forename: Anthony
authors.initials: A
authors.lastname: Peterson
authors.forename: Cindy
authors.initials: C
authors.lastname: Krol
authors.forename: William
authors.initials: W
authors.lastname: Adams
authors.forename: Rebecca
authors.initials: R
authors.lastname: Tung
mesh_terms: D001706:Biopsy; D004396:Coloring Agents; D004817:Epidermis / Q000473:pathology*; D005404:Fixatives; D005557:Formaldehyde; D005840:Gentian Violet; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D008853:Microscopy; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011787:Quality of Health Care; D015203:Reproducibility of Results; D013048:Specimen Handling / Q000379:methods*; D013194:Staining and Labeling; D014796:Visual Perception; D057188:Workflow
chemical_list: D004396:Coloring Agents; D005404:Fixatives; D005557:Formaldehyde; D005840:Gentian Violet