Melanocytic Dermpath Basics: Benign Nevus
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Published 2018-04-05
Part 1 of my (in progress) video series about the pathology of melanocytic skin lesions. This video discusses the basic features and patterns that are commonly seen in benign melanocytic nevi, including: symmetry, maturation, basally-oriented melanocytes (i.e. - lack of upward pagetoid spread), well-spaced junctional melanocytes (i.e. - lack of confluent growth), bland cytology (lack of atypia), and low or no mitotic activity. These are not hard and fast rules, just a helpful framework to serve as a starting point for understanding how to diagnose melanocytic lesions histologically. Exceptions exist for pretty much all of these things. Watch the video to learn more. Many thanks to my awesome medical student, Gray Orman, for transcribing this entire video so that closed captions would be available for viewers who need them!
Topics discussed (special thanks to viewer Ronald Chan for listing these timestamps!):
0:01 Introduction and disclaimers
4:03 Shave biopsy
6:03 Symmetry
9:06 Junctional, Intradermal and Compound Nevus
15:02 Maturation and type A B C melanocytes
26:10 (Lack of) Cytological atypia
34:20 Dysplastic nevus
45:44 Congenital features
1:00:41 Neurotized look
1:02:30 Fat metaplasia
1:03:17 Pseudovascular changes
1:07:22 Hyperpigmentation
1:09:18 Subcutis extension
1:12:09 Nevus vs Neurofibroma
Other videos that will help you better understand this topic:
Normal Skin Histology: • Normal Skin Histology - Explained by ...
Melanoma Basics: • Melanocytic Dermpath Basics: Melanoma
Melanocytic Immunohistochemistry: • Melanocytic Dermpath Basics: Immunohi...
Disclaimers: As I said in the video, distinguishing nevus from melanoma is serious business. My video does not replace the need for getting an expert consultation should you encounter a difficult melanocytic lesion in your practice. Also, melanocytic dermpath has areas of controversy with differing strongly held points of view. by various experts in the field. This video represents MY current views as of April 5, 2018. My views have changed since I started practice, and I suspect (and hope) that they will continue to evolve over time. You (or your mentors) may do things differently than I do. That's ok by me. I'm just sharing the way I currently think of melanocytic lesions with the hope that viewers may find it useful. My goal is to educate, not to create dogma.
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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All Comments (21)
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A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology)
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Dr Gardner, I'm a first year anatomical pathology registrar and just wanted to say your tutorials have helped me immensely during my first year of training so thank-you, you are the GOAT of dermatopathology
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Dr. Gardner, Your teaching style is truly special—fun and engaging. Watching your videos is like reading a beautiful novel; I can’t stop until the end! You break down complex topics as effectively as bile salts emulsify lipids in the gut, making dense material easy to mentally digest and understand. I also love teaching and strive to simplify things for my learners. I’m currently a PGY-3 pathology resident, studying and applying for dermatopathology fellowship, and your videos are the best resources I’ve found. I recently got your Dermpath Survival Guide, and reviewing the same topics in the book right after watching your videos makes learning both fun and beautiful. I can’t thank you enough. For those who love dermpath, this is like getting the pearls of 100 hours signing out with an experienced and generous dermatopathologist, but on your own time of preference! It couldn’t be better. For fun: This morning, while finishing one of your videos, a co-resident passing by in the corridor recognized your voice instantly and said, “Dr. Jared Gardner! You can always recognize his voice" 😊 Thank you for sharing your gift for teaching. It’s truly priceless!
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Thank you for the great video and all the beautiful slides! 0:01 Introduction and disclaimers 4:03 Shave biopsy 6:03 Symmetry 9:06 Junctional, Intradermal dermal and Compound Nevus 15:02 Maturation and type A B C melanocytes 26:10 (Lack of) Cytological atypia 34:20 Dysplastic nevus 45:44 Congenital features 1:00:41 Neurotized look 1:02:30 Fat metaplasia 1:03:17 Pseudovascular changes 1:07:22 Hyperpigmentation 1:09:18 Subcutis extension 1:12:09 Nevus vs Neurofibroma
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Superb....where were you 25 years ago!? Ha....thanks man. So incredible that young (and old, ha) path folk now have access to this these incredible resources!
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Dr. Gardner, thank you so much for this and all your videos! The idea of high quality material accesible to everyone around the world is gamechanger. You are an inspiration! Thank you for your work!
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Great teaching Great service to global Pathology ...!
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Love when you add in things not found in textbooks like "I don't add this into the diagnosis" - truly, your one of my favorite dermatopathologists!
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Excellent explanation, as always! Your videos have helped me a lot with my dermatopathology routine. Thank you very much, doctor Gardner.
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Thank you so much for your extremely amazing effort These videos are very beneficial and have added alot to my information
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Thank you so much for another amazing video. You are a gifted teacher. Hope you continue to spread the light.
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You are a great teacher dr. Gardner! ty for all the informative videos
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this video is really amazing..thank you so much for every single info in this masterpiece.
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Great video! Thank you for sharing your knowledge and your beautiful slides. Greetings from Spain.
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Thank you sir! Great videos. Thank you for making dermpath as simple as a halwa (South Asian sweet dish). Love and Respect from Pakistan!
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Excellent teaching session like many of your videos, thank you for the time and efforts.
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Thank you Dr.Gardner. These lectures are of immense help and the way you have put the timestamps for longer lectures helps immensely to revise the topics.
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Now I can say I have learned and feel more comfortable when dealing with a melanocytic lesions. You have encouraged me to think about doing a Dermpath fellowship Thanks a lot
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Thanks a true treasure ❤️. Looking forward to the video on dysplastic naevi , would be nice to just see your approach to a variety of dysplastic naevi, perhaps touching on more difficult cases on the borderline between dysplastic naevi and melanoma.
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I just found these videos ad they are extremely helpful. Thanks heaps, much appreciated :))
