Under The Microscope: Dermatopathology

Wednesday, 26 April, 2017

The Dermatopathology Laboratory at Viapath is known as a centre of excellence for dermatological specimens. The laboratory is integral to The St John’s Institute of Dermatology, which is one of the world’s leading centres for patients with skin diseases and provides support to Guy’s and St Thomas’ Hospital’s plastic surgery department and to GPs with skin-related investigations.

As a specialist laboratory, it processes over 14,000 routine cases a year; including approximately 3,000 complex referral cases from across the UK and internationally. The laboratory’s fully automated immunocytochemistry service performs over 24,000 tests annually and employs a panel of over 120 antibody tests as well as supporting over 1,000 provisions of Mohs micrographic surgery.

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The laboratory has expertise in Mohs and slow Mohs micrographic surgery techniques, which is an extremely effective procedure that involves investigating theremoval of skin cancers by performing extensive section cutting of fresh frozen tissue in order to demonstrate more precise clearance of tumour margins. These skin cancers are most commonly basal cell carcinomas, squamous cell carcinomas and lentigo maligna melanomas and are found mainly, although not exclusively, on facial sites. The Mohs micrographic surgery has a cure rate of 95% to 98%, depending on anatomical site.

Although the laboratory deals with skin cancers predominantly, it also performs extensive histological investigations into alopecia and trichogram assessments for patients with hair loss disorders. Alopecia is a common problem, but the root causes are not always understood. This growing specialism is one that generates interest nationally.

The department has a keen interest in both lymphoma and melanoma diagnostic and research work. It is a major referral centre for cutaneous T cell lymphoma, receiving referrals from all over the country.

The department also supports an active research interest in melanoma, assessing prognostic indicators and supporting assessments of treatment strategies, such as BRAF investigations supporting molecular assessments of paraffin wax tissue curls of patient blocks.

The laboratory has a reputation for innovation and scientific endeavour. For example, the laboratory patented a new histological product to improve the process of dealing with hard tissue samples and manufactured this through an external company for use in histopathology laboratories both nationally and internationally.

No laboratory would function well without a well-trained and dedicated workforce. The department has 15 scientific staff with a full spectrum of grades, from band 2 MLA to band 8 BMS. The laboratory is led by Dr Guy Orchard,  chief examiner for Cellular Pathology for the Institute of Biomedical Science as well as being an assessor for Immunocytochemistry UKNEQAS and UKNEQAS Cellular Pathology Technique (CPT) and Lead for Mohs. Guy is also a lecturer and short course coordinator.

For further information please contact:

Dr Guy Orchard, Consultant Grade Biomedical Scientist/Laboratory Manager

Email: guy [dot] orchard [at] viapath [dot] co [dot] uk (subject: pathology%40viapath)

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