From concord america ecology here’s dr.
clay Cockerell a dermatologist and dermat a pathologist here at cock-crow two out of college and i’m here to talk to you today about one thing that we happens not infrequently and that is what we refer to as getting requests for margins on biopsies Marge’s are commonly in fact.
Routinely reported when a clinician does an excision for example a basal cell carcinoma.
That may be sent to a Mohs surgeon or then an elliptical fashion there we automatically report margins because you want to.
Know if the lesion has been completely removed or not sometimes we get margin requests for shave biopsies and sometimes those can be valuable in other words if you think you have a small basal cell carcinoma you’ve done a shave biopsy of the lesion you ask for margin and we can tell you it does not seem to be left in the specimen it doesn’t extend to either of the edges of the base and that often is enough.
And you can follow a patient if it doesn’t come back no additional surgery is necessarily required however sometimes we get margin requests on things such as malignant melanoma on a shave biopsy and.
Those are virtually never adequate for complete removal the melanoma cells can track down a hair follicle they sometimes may not seem to be.
Present at the edge of the specimen think still be deeper into the block so we can only give you an approximation as to whether or not that really and truly is adequate therapy and for malinga melanoma I would strongly recommend.
Report for treating the patient we also sometimes.
Get margins for lesions that are benign like for example a seborrheic keratosis or maybe even a wart sometimes even an inflammatory disease we.
Sometimes get margin requests for things such as psoriasis or for nail clippings things of that nature even alopecia this may be because the nurse or the medical assistant is checking off the margin requests all automatically clearly most dermatologist or even other physicians that perform dermatology work.
Are not really truly interested in whether psoriasis extends to a margin for example but nevertheless we still report that and sometimes we even get calls from office staff saying that they didn’t report the margin on an inflammatory skin.
Disease so if you really want these in their meaning – you were more than happy to report those but in some cases it does lead to more time and energy on your office staff receiving phone calls and other things for things that really may not mean too very much mean very much to you.
So I was just asked that if you really are truly interested in a margin request make sure that you understand that it is being requested some cases you may not even know that it’s being requested and understand the limitation of a margin request on a biopsy versus a margin request on an excision we’re always here to try to do the best we can to sort of.
You and your patients and create the best experience for your office staff and for you thank you very.
Much for listening to learn more about joining the cockerel dome at a pathology family visit durn path comm or contact us at you.