The majority of skin biopsises and excisions are successfully analyzed using routine histopathologic examination (H&E). Special stains and ancillary testing are ordered only by the Dermatopathologists when necessary or when requested by the clinician.
Histochemical Special Stains
•Acid-fast Bacillus, Kinyoun’s
•Alcian blue / PAS
•Alcian Blue
•Amyloid, Congo Red
•CAE (Chloroacetate esterase)
•Colloidal Iron
•Diff-Quick Giemsa
•Elastic
•Fite, Melanin
•Fontana-Masson
•GMS, fungal
•Giemsa
•Glycogen
•Gram
•H&E
•Iron
•Masson Trichrome
•Melanin bleach
•Mucicarmine, Mucin
•Oil Red O
•PAP (Papanicolaou)
•PAS (Periodic Acid Schiff’s)
•PAS w/ diastase
•PAS-fungus
•Reticulin/Nuclear Fast Red
•Steiner
•Toluidine blue
•Warthin-Starry
•Wright-Geimsa

Immunofluorescence
•Albumin
•C3
•Fibrin
•IgA
•IgG
•IgM

Immunohistochemistry (IHC)
•ALK-1
•BCL-2
•BCL-6
•BerEP4
•CD1a
•CD3
•CD4
•CD8
•CD20
•CD30
•CD31
•CD34
•CD45 (LCA)
•CD56
•CD61
•CD68
•CD79a
•CD117 (c-kit)
•CD138
•CD163
•Chromogranin A
•CK (Cytokeratin) AE1/AE3 (pankeratin)
•CK 5/6
•CK 7
•CK 20
•Desmin
•E. cadherin
•EMA
•Factor 13a, Xllla
•Glycophorin A
•HHV-8
•HSV-1
•HSV-2
•Mart-1, (Melan A)
•MiTF

•MLH-1
•MSH-2
•MSH-6
•MPO
•NKlC3
•p53
•p63
•Podoplanin
•S-100
•SMA, smooth muscle actin
•SMMhc
•Treponema Pallidum (Syphillis,
Spirochete)
•Tyrosinase
•Vimentin
•VZV (Varicella Zoster)

*Others available on request.

In Situ Hybridization (ISH)
•Human Papilloma Virus (HPV1, 2), High
Risk/Low Risk

Immunology/Molecular Studies
•BRAF Mutational Analysis
•B Cell gene rearrangement
•T Cell Receptor gene
rearrangement
•Flow Cytometry

**Other testing available on request or as needed

• Access requires a unique user name and password
• Reports available in real time
• No software to purchase or install
• Internet access to pathology reports from any computer
• Easy search and sort options (view, print, download reports)
• 100% HIPAA compliant, with built-in data security (SSL at 128-bit encryption)

Diseases of the lower extremities require specialized medicine.

KDL’s board-certified dermatopathologists provide unparalleled diagnostic interpretation and clinician support for all types of skin, soft tissue and nail disease, allowing podiatrists to provide the best possible patient care.

Specialized Diagnosis

• Diagnosis of skin lesions, soft tissue, bone and nail disorders
• Flat fee for routine fungal nail plate biopsy (H&E + PAS). Contact client services for more information
• Nail bed, matrix and apparatus biopsy interpretation available for tumor and inflammatory skin diseases

Concise Reports, Delivered Fast

• Diagnostic reports available ≤ 24 hours
• Dermatopathologists readily available by phone for consultation
• Access reports securely online, with no software to purchase or install

Unparalleled Client Services

• FNA procedure training for clinicians
• FNA interpretation, with physician office collection available
• Complimentary billing of Medicare and Third Party Insurance*

*KDL Pathology is committed to high quality, affordable patient care. As such, we are a participating, in-network provider for laboratory and pathology services on all major medical plans. We are sensitive to the fact that some patients have no insurance or high deductible insurance plans and maintain patient-friendly billing policies.

• All KDL Veterinary Pathologists are ACVP board-certified
• Rapid turnaround time (within 24 hours or less of specimen receipt)
• Responsive client communications, vetpath available via email or phone
• Competitive pricing
• Customized reporting
• Barcoded requisitions, supplies and shipping (free of charge)

• First specimen, $58
• Each additional specimen (same patient), $44

• First specimen, $48
• Each additional specimen (same patient), $38

Education. Support. Access.

• KDL Healthcare practitioner continuing medical education programs
• Sun safety patient education activities
  • School health fairs
  • County health department fairs
• Skin cancer awareness patient education activities
• Cancer Support Community of East Tennessee
• Tennessee Cancer Coalition
• Knoxville Area Project Access (KAPA), an initiative led by the physicians of the Knoxville Academy of Medicine to provide access to healthcare for low-income, uninsured residents of Knox County, TN
• Together!HealthyKnox, a health improvement initiative by the Knox County Health Department (KCHD), emphasizing a community approach to better health

“Excellent, reliable, consistent, professional service!”

“Always excellent service and quality.”
Dr. Lawrence Bushkell, Knoxville Dermatology Group

“We love you!”
Dr. Jean Byarlay, Healthstar Physicians, PA

” An excellent source, easy to work with and i appreciate the accurateness of the pathology reports.”
Dr. Kamilia Kozlowski, Knoxville Comprehensive Breast Center

“Entire staff that we have ever dealt with is wonderful, always polite and courteous.” They make our day!
Dr. Charles Frazier

“There is no other practice I call that is more responsive than you. Thanks for everything.”
Dr. Joni Sago, Dermatology Associates of Kingsport

“Everything is exceptional. Thanks!”
Dr. Charles Fulk

“Great doctors, great help. Thanks!”
Dr. Charles Huddleston, Dermatology Associates of Knoxville

“Great Dermpath Group-best around!”
Dr. Maria Rueda

“You guys are the best. We appreciate you.”
Dr.Cynthia Kang-Rotondo, Dermatology Specialists

• More than 2 million non-melanoma skin cancers are diagnosed annually.
• Basal cell and squamous cell carcinomas are the two most common forms of skin cancer, but both are easily treated if detected early.
• Current estimates are that one in five Americans will develop skin cancer.
• Melanoma incidence rates have been increasing for at least 30 years. In the most recent time period, rapid increases have occurred among young, white women (3 percent per year since 1992 in those ages 15 to 39) and white adults 65 years and older (5.1 percent per year since 1985 in men and 4.1 percent per year since 1975 in women).
• Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and adults 15-29 years old.
• Melanoma is increasing faster in females age 15-29 than males in the same age group. In these females, the torso is the most common location for developing melanoma, which may be the result of high-risk tanning behaviors.
• Melanoma in individuals 10-39 years old is highly curable, with five-year survival rates exceeding 90 percent.
• One in 58 men and women will be diagnosed with melanoma during their lifetime. Caucasians and men older than 50 are at a higher risk of developing melanoma than the general population.
• It was estimated that there will be about 114,900 new cases of melanoma in 2010 — 46,770 noninvasive (in situ) and 68,130 invasive (38,870 men and 29,260 women).
• One American dies of melanoma almost every hour. In 2010, it is estimated that 8,700 deaths will be attributed to melanoma — 5,670 men and 3,030 women.
• The World Health Organization estimates that as many as 65,161 people a year worldwide die from too much sun, mostly from malignant skin cancer.
• People who have more than 50 moles, atypical moles, or a family history of melanoma are at an increased risk of developing melanoma.
• Approximately 75 percent of skin cancer deaths are from melanoma.
• The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 98 percent.
• Five-year survival rates for regional and distant stage melanomas are 62 percent and 15 percent, respectively.
• In 2004, the total direct cost associated with the treatment for non-melanoma skin cancer was $1.5 billion.
• The American Cancer Society recommends a skin cancer-related checkup and counseling about sun exposure as part of any periodic health examination beginning at age 20.
• Individuals who have a history of melanoma should have a full-body exam at least annually and perform regular self-exams for new and changing moles.

References:
1. American Cancer Society. Cancer Facts and Figures 2010. www.cancer.org/downloads/STT/Cancer_Facts_and_Figures
2. Robinson JK. Sun Exposure, Sun Protection, and Vitamin D. JAMA 2005; 294: 1541-43.
3. Linos E, Swetter S, Cockburn MG, Colditz GA, Clarke CA. Increasing burden of melanoma in the United States. J Invest Derm. 8 January 2009 doi:10.1038/jid.2008.423.
4. Cancer Epidemiology in Older Adolescents & Young Adults. SEER AYA Monograph Pages 53-57. 2007.
5. Melanoma of the Skin, Cancer Fact Sheets, National Cancer Institute, SEER database, 2007..
6. World Health Organization, Solar ultraviolet radiation: Global burden of disease from solar ultraviolet radiation. Environmental Burden of Disease Series, N.13. 2006.
7. Bickers DR, Lim HW, Margolis D et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. Journal of the American Academy of Dermatology 2006; 55: 490-500.
8. Berg A. Screening for skin cancer. U.S. Preventive Services Task Force, 2007.

Copyright © 2010 American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission.