Extreme winter weather: A force to be remembered in dermatopathology

Area of Science:

• Dermatopathology
• Histopathology
• Medical Diagnosis

Background:

• Accurate dermatopathology relies on distinguishing tissue artifacts from genuine pathologies.
• Familiarity with common artifacts is essential, but less common ones, like freezing artifact, can be overlooked.
• Extreme weather events can introduce novel or less-recognized artifacts into tissue samples.

Observation:

• A severe winter storm in February 2021 impacted the Southern United States, leading to unusual conditions.
• This event resulted in freezing artifacts in dermatopathology specimens that obscured common diagnoses.
• Three specific cases illustrate how freezing artifact can confound typical dermatologic diagnoses.

Findings:

• Freezing artifact can mimic or mask various dermatologic conditions, challenging accurate histopathological interpretation.
• The severity of the winter weather directly correlated with the prevalence and severity of the observed freezing artifacts.
• Specific diagnostic features were altered or rendered unrecognizable due to ice crystal formation within tissues.

Implications:

• Dermatopathologists, especially in temperate regions, need to be aware of and prepared for potential freezing artifacts.
• Implementing preventative measures during sample collection and transport in extreme weather is vital.
• Enhanced understanding of environmental artifact impact improves diagnostic accuracy and patient care in challenging conditions.