Utility of deeper sections and special stains for dermatopathology specimens

Special (non‐hematoxylin and eosin) stains and deeper sections are routinely used in dermathopathology, although their utility has not been well established. All cases requiring special stains or deeper sections over a three‐month period were reviewed to see how often these additional studies contributed to accurate diagnosis. In our series, deeper sections provided diagnostic information to the pathologist in 37.3% [95% confidence interval (CI) 28‐46%] of the cases in which they were performed. Deeper sections are more likely to provide a more accurate diagnosis (23.6%, 95% CI 16‐32%) rather than establish a new diagnosis not seen on the original sections (13.6%, 95% CI 7‐20%). Their use is especially helpful in assessing the presence or absence of cutaneous malignancy rather than in diagnosing inflammatory skin processes. Special stains contributed to the diagnosis in 21.1% (95% CI 11‐32%) of cases. When special stains were performed to diagnose an infection they were effective in 14,7% (95% CI 6‐24%) of the cases When special stains were performed to diagnose any other pathologic processes (neoplasm, inflammation, collagen vascular disease, and amyloid) they were effective in 31.8% (95% CI 24‐44%) of the cases.