Using Frozen Sections for Primary Diagnosis of Skin Lesions?

As a board certfied dermatologist and Mohs surgeon, I have had a lot of experience looking at countless slides both via frozen section and via parafin block sections. In many cases a quick frozen section can be of benefit in an initial diagnosis but there are ultimately drawbacks with frozen sections. Tissue cuts are thicker, so there is loss of cell clarity and many cells, particularly melanocytes, shrink away to the point of losing their morphology when the tissue is... more

Permanent sections are more reliable than frozen section. Special stains can be used that are not available in frozen sections to ferret out the more difficult lesions. Once a diagnosis is confirmed, then Mohs or wide excision with cross section frozen section control can be used as indicated in appropriate lesions. Best wishes. Knowledge is power. Luis F. Villar MD FACS

A couple things: 1. I agree with Dr. Swengel's statements about when and why these types of frozen section biopsies just don't make sense, or don't provide a clear enough view to give proper patient care and diagnosis. 2. Dermatology offices aren't set up to be labs. They can be set up to do Mohs, but that requires a specific set of dyes, and types of cuts and slides. A full lab set up takes an inordinate amount of space, and most dermatologists can't have that on site, not to... more