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The Stanford Dermatopathology Service provides the full range of diagnostic
services for skin biopsies. We are committed to
Provide the highest quality patient care
Serve as competent and easily available consultants to our
referring physicians
Advance translational and clinical research
Train future community based and academic pathologists,
dermatologists and dermatopathologists.
Consultation Services
Fellowship
Faculty and Staff
Contact us
Newsletter
Consultation Services
We provide the full range of diagnostic services for wet tissue specimens and
glass slides sent in consultation.
Our Services include:
Wet Tissue Analysis and Slide Consultations
We supply free formalin filled specimen containers. Daily courier service is
available within the Bay Area. Please call our office to request a pick-up. For
clients outside our courier area we provide specimen transport by FedEx. Please
call for preaddressed mailers.
We strongly encourage the submission of clinical photographs of patients who
undergo biopsy for a rash or who present with unusual pigmented or nonpigmented neoplasms. Electronic submission of digital photographs is easy. Just
send an e-mail to dermatopathology@stanford.edu and attach a digital
photograph of the lesion of interest. This e-mail account is secure and can only
be accessed by faculty and fellows in dermatopathology. Please maintain patient
privacy and do not include full facial photographs or patient names in the e-mail.
In our interpetation of skin biopsy specimes we resort to ancillary techniques as
necessary. These include histochemical stains, immunophenotyping,
immunofluorescence and if necessary molecular techniques. We practice
judicious use of special techniques and do not apply them indiscriminately.
The Dermatopathology Service is an integral part of Stanford Pathology
Consultants. We operate as a group practice. You can be assured that difficult
cases will be shared among all dermatopathologists and with other faculty
members. Among other areas of interest, Drs. Kempson, Hendrickson, Longacre
and Berry offer special expertise in soft tissue pathology and with
squamoproliferative lesions. Drs. Arber, Warnke, Natkunam, Atwater and George
provide invaluable experience for difficult hematolymphoid lesions.
Biopsies for alopecia
We provide interpretation of scalp biopsies for alopecia. Our biopsies are
embedded horizontally and examined according to an alopecia protocol. The
diagnostic yield of a horizontally embedded scalp biopsy is far superior to the
amount of information that can be gleaned from a vertically embedded specimen.
When submitting a biopsy to assess the type of alopecia, please make sure that
the appropriate box on our requisition sheet (link) is checked or that the word
“alopecia” is written on the sheet in a prominent position.
Immunofluorescence
We perform direct immunofluorescence for autoimmune and blistering disorders
on tissue samples and indirect immunofluorescence on serum. We also perform
immunomapping of the basement membrane region for epidermolysis bullosa
congenita .
Please submit tissue for direct immunofluorescence in Zeus or Michels transport
medium. Zeus transport medium is supplied by our laboratory, please call our
office. Once in transport medium, tissue is stable for several weeks at room
temperature and can be picked up or shipped with your routine formalin fixed
specimens.
Please submit serum for indirect immunofluorescence in a red top tube. We use
monkey esophagus as substrate for our indirect assay. Immunofluorescence
studies are run daily and the turn around time is less than 72 hours.
Choice of biopsy site
Immunophenotyping
Our immunohistochemical laboratory is fully equipped to perform a wide array of
antibody stains. We practice judicious use of special techniques and do not apply
them indiscriminately.
Molecular diagnosis
The molecular diagnosis laboratory is directed by Drs. Iris Schrijver and James
Zehnder. We perform gene rearrangement studies for T- and B-cell clonality by
PCR, tests for microsattelite instability and PCR or FISH for chromosoamal
translocations.
Slow Mohs’ technique
“Slow Mohs” is a very useful technique for histologically subtle neoplasms that
may be difficult to recognize on frozen sections that are used in the regular Mohs
procedure. Examples include lentigo maligna, sebaceous carcinoma with
intraepidermal pagetoid spread, extramammary Paget’s disease,
dermatofibrosarcoma protuberans and acrolentiginous melanoma in situ. Slow
Mohs represents a staged excision but in contrast to Mohs micrographic surgery,
the margins are processed as rush permanent sections. We have successfully
employed this technique for several years. This is a technically complex
procedure and its success depends on collaboration and precise communication
between surgeon and pathologist.
We have had the best results with the following technique:
1. alert our laboratory that you are planning a slow Mohs procedure
2. it is paramount that we can evaluate the original neoplasm. If the original
biopsy was not reviewed by us, this can be archieved by submitting the
debulking specimen, provided it contains tumor or by including the original
biopsy slide with the Mohs margins.
3.
Epidermolysis Bullosa
We evaluate biopsies for the diagnosis of epidermolysis bullosa with electron
microscopy and with immunomapping of the basement membrane zone. We
provide this service in close collaboration with Dr. Anna Bruckner, who directs
the pediatric dermatology service at Stanford and with Dr. Peter Marinkovich,
director of the clinic for bullous disorders.
It is paramount that diagnostic biopsies will be performed on a freshly induced
blister. This is best achieved by rotating a pencil eraser on intact skin. Please
perform 2 punch biopsies (4 mm) at the edge of the blister, containing about 1/3
lesional and 2/3 perilesional skin. Please do not bisect the punch biopsies. The
skin in EB patients is usually so fragile that bisecting a punch biopsy will denude
the epidermis and render the specimen useless. Please do not select an existing
blister, even if it appears fresh, clinically. Early reepitheliazation will prevent us
from establishing the level of the split.
Please submit one biopsy in Zeus or Michels fixative for immunomapping and the
second biopsy in Glutaraldehyde for EM. No H&E is necessary unless you
suspect an autoimmune blistering disorder. Include clinical history and clinical
findings.
Pick up service/ Specimen transport
Call our office 650-723-6736
Request specimen containers and requisition sheets
Call our office 650-723-6736
Insurance Information
When complete demographic & insurance information accompanies a specimen,
we will routinely direct our billing to the designated third party payor. Our
physician group is contracted with most of the large insurers & Medicare & MediCal (in state only). If the patient has HMO coverage, we ask that an authorization
for our services accompany the specimen. Billing for the professional component
services occurs separately from the technical (i.e., facility) component services
so a patient may receive two different statements when a copayment/deductible
is involved. If you need additional
information regarding the billing processes, please contact our administrative
manager, Leigh Stacy, at 650-498-7840 or at Leigh.Stacy@Stanford.edu.
Contact us:
e-mail: dermatopathology@stanford.edu
Dermatopathology Office, Gloria Magpantay: 650-723-6736
Specimen pick up:
Supplies:
Dr. Sabine Kohler: 650-498-6991
Dr. David Cassarino: 650-725-9860
Dr. Sam Dadras:
Dr. Uma Sundram: 650-498-4401
Please submit the specimens together with a requisition sheet or cover letter to
Stanford Dermatopathology Service
Department of Pathology – H2110
Stanford Medical Center
300 Pasteur Drive
Stanford, CA 94305
Downloadable req sheet
Explanations for requ. Sheet
Insurance information
Fellowship:
link to pathology page
Instructions for application
The Dermatopathology Fellowship at Stanford accepts applications from qualified
candidates. To be eligible you need to be board certified or eligible for
certification by the American Boards of Pathology or Dermatology.
We would like to have your completed application for Dermatopathology by
12/31, 18 months preceding the start of the fellowship. The application consists
of a CV, a personal statement and three letters of reference. We will interview in
January and commit to a candidate by March, 15 months prior to the fellowship.
Former fellows
Dr. Susan Kindel
Dr. Meg Stewart
Dr. Julie Desch
Dr. John Moretto
Dr. Sabine Kohler
Dr. Susan Detwiler
Dr Maria Mancianti
Dr. Lyndon Su
Dr. Khan Tran
Dr. Bijan Haghighi
Dr. Pam Sakkinen
Dr. Madhu Dahiya
Dr. Dominik di Maio
Dr. Uma Sundram
Dr. Alison Uzieblo
Dr. Jason Robbins
Dr. Anu Jayaraman
Faculty and Staff
Pictures of all faculty + Gloria + Leigh with links to Stanford faculty directory
Newsletter: