Sebaceous carcinoma in Western Australia: A registry-based study of site-related outcomes.

Sebaceous carcinoma is a rare cutaneous malignancy which is typically regarded as relatively aggressive and has traditionally been subdivided into periorbital or extraorbital tumours. We conducted a retrospective review of all cases of sebaceous carcinoma reported to the Western Australian Cancer Registry between 1987 and May 2019. The incidence of sebaceous carcinoma in Western Australia has increased over the last three decades, with extraorbital tumours being much more common than periorbital tumours. Very few sebaceous carcinomas have led directly to the death of patients; however, adverse outcomes were more likely with periorbital tumours, in particular local recurrence and the need for major surgical intervention.

Pruritus as an early sign of abnormal scarring in the re-epithelialising phase of Toxic Epidermal Necrolysis.

We present a 28-year-old remote-living male who presented to our dermatology clinic with increasing pruritus over his torso and limbs in the context of a recent admission for Toxic Epidermal Necrolysis (TEN) secondary to paliperidone depot. Our case demonstrates that pruritus in the re-epithelialising phase of TEN may be a sign of abnormal scarring. Early assessment and measurement for compression garments is recommended.

'Why don't they ever call?' Expectations of clinicians and pathologists regarding the communication of critical diagnoses in dermatopathology.

Certain diagnoses in dermatopathology have significant implications for patient management and on occasion appropriate clinical care may be facilitated by a phone call from the reporting dermatopathologist to the referring doctor. Whether this is appropriate depends on a number of factors. The concept of 'critical diagnoses' is now well established in surgical pathology, having evolved from critical value policies in clinical pathology and haematology. However, only limited attempts have been made to assess perceptions among different clinical groups. We designed a survey to assess the attitudes of pathologists, dermatologists, surgeons and general practitioners as to what circumstances warrant telephone contact in addition to a standard written report, as well as their approaches to routine histology follow-up. The survey was distributed Australia-wide via a combination of specialist colleges, medical forums and collegiate contacts. A total of 262 responses were received, encompassing representations from all of the targeted specialties. Approximately 20% of respondents were aware of adverse outcomes or 'near misses' which they felt had been due in some part to inadequate communication of histopathology results. While most practitioners have formal systems in place to review histopathology reports, this practice is not universal. There were a number clinical situations where there was a discrepancy between the expectations of clinicians and those of pathologists, in particular with regard to a diagnosis of cutaneous melanoma as well as cutaneous lesions which might be associated with inherited cancer syndromes. It is our hope that the results of this study will facilitate discussion between pathologists and referring clinicians at a local level to minimise the potential for miscommunication.