Brie Schmidt
@BSchmidtDpath
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Great food/healthy lifestyle, horror films, paying it forward, and kindness are my main things.
Joined November 2017
#dermpath #pathology #dermatology Recent case I had of cutaneous involvement by known granulomatosis with polyangiitis. These were photos I shared with the clinician who was concerned for infection.
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More very good #dermpath learning cases to come. It’s been very busy lately and I fell off the map.
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3) IHC to confirm (🧦10 and PRAME). I let out an audible gasp when I got saw them, but was also very relieved that I didn’t go down the tubes with this one (I had great training from @MightyDermPath)! Got the PRAME after the 🧦 for re-excision feasibility purposes.
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2) Where is the disruption? It’s not at the DEJ like one would see in an interface process. It’s INTRAEPIDERMAL (unzippering). Remember melanocytes lack desmosomes=no adherence Also, see how jumbled and grey the epidermis is? Another clue.
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1) Another land mine of a case. TRUST YOUR EYES AND TRAINING. 70 y.o 👩 upper arm. “NUB vs BCC” #dermpath Looks like a BLK, right? What is a big clue that it’s NOT!
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Scabies Is Making a Comeback - WIRED
apple.news
Cases of scabies, a highly contagious parasitic skin disease, are on the rise across Europe. The UK in particular is struggling with a shortage of treatments.
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6yo with recent ptosis Pic B: Squamous papilloma with marked inflammation?? Pic C: High power shows small round atypical cells. Final diagnosis: Botryoid type embryonal rhabdomyosarcoma Dr. Stagner and Zembowicz #ophtalmicpath #dermpath #PathX #PathTwitter #pathologists
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Doctors are pushing Hollywood for more realistic depictions of death and dying on TV - NPR
apple.news
Clinicians who work with people at the end of life say the most common television depictions of death aren't representative of what happens in the real world. They want to flip the script.
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40yo. Vague GI symptoms and subsequent rash of edematous and erythematous plaques, starting intertriginous, spreading to trunk and extremities. First pruritus, then tender. No response to low dose steroids. Completely cleared after higher dose. Thx @mccalmo for lighting the way.
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Answer: This is a porokeratoma! At low power you see diffuse wave-like, columnar cornoid lamella with an abrupt transition from normal. Read more about this entity here:
onlinelibrary.wiley.com
Click on the article title to read more.
#COTW with PGY1 @meredithkherman featuring a variant in #dermpath. Shave biopsy of groin lesion. What histologic features do you see? What is your differential diagnosis?
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Another frightening reason to slow down and go on high-power! 😱#dermpath
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So to recap: this is (macular) localized cutaneous amyloidosis. Presents as (usually) pruritic hyperpigmented macules/patches, usually on upper body/extremities. Amyloid is keratin-derived. Amorphous eosinophilic deposits + (some)🐷 incontinence.
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This is a CK5/6 (of course I also got a PAS which was neg for fungi). Look @ how that material lights up! This is keratin-derived amyloid. Since there’s minimal epidermal change, I decided “c/w macular amyloid” (vs lichen).
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I believe we can. Now, let’s look on high-power. What’s going on? How would you describe the papillary dermis? What’s your ddx and which stain(s) should you get?
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#dermpath for trainees. Middle aged adult, elbow. “Ddx dermatitis vs psoriasis” What is your low-power impression? Can we exclude psoriasis already?
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📸 https://t.co/vcdJ7jS7xk Let your voice be heard on non-compete clauses by March! #noncompete
#fairwages
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