Spring 2025 Newsletter
See you in Nashville!
The 31st Annual Meeting May 16-17 at the Gaylord Opryland Resort in Nashville, Tennessee is quickly approaching! Visit the Annual Meeting website to see the final program. Did you miss the registration window? Don’t worry, you can still register on-site on May 15 from 1:00 p.m. – 5:00 p.m. The ASMH registration table will also be open Friday, May 16 from 6:30 a.m. – 5:00 p.m., and Saturday, May 17 from 6:30 a.m. – 4:00 p.m.
Is this your first meeting? How about your 31st? Share your experience with the ASMH Newsletter Committee.
Embracing the Beginner’s Mind: Staying Current Through Connection
By Stacie Eckhout, BHSc, CDT, CCMA
One of the most valuable ways I stay current in the field is by connecting with other techs—whether that’s through conferences, professional groups, or social media. These interactions have introduced me to newly invented tools and fresh approaches that I might not have discovered on my own. Sometimes it's a clever trick with embedding; other times, it’s a product that streamlines workflow or improves slide quality. I love learning about what others are doing in their labs and experimenting with new methods to see how they might enhance my work.
I always tell myself, I can improve, and I push myself to keep learning and evolving. This mindset is rooted in something I’ve embraced over the years—Shoshin, a Japanese term that means “beginner’s mind.” Shoshin is about approaching your work with curiosity, openness, and a willingness to learn, no matter how experienced you are. It reminds me to stay humble, curious, and teachable. Even after years in the field, I believe there’s always room to grow.
We, as the ASMH community, have a valuable network—our combined years of experience are vast. There’s so much we can learn from one another. I encourage you to tap into that knowledge: author an article for our newsletter, consider presenting at a meeting next year, try new embedding techniques, and see if you like them. Attend a conference, ask questions, make connections, and share what you’ve learned.
Staying current isn’t about being trendy, it’s about being open. If we all keep learning and growing, together we can become even better at what we do. That mindset benefits not only us as technicians, but the patients we serve every day. I look forward to connecting and learning more from our members! See you in Nashville!
Enhancing Mohs Surgery: The Role of Integrating IHC into the H&E Process
By Justin Jefferson, MB(ASCP)CMHTLCM
Hematoxylin and eosin (H&E) staining is the foundation of Mohs frozen section analysis. However, it has limitations in detecting certain tumors. Immunohistochemistry (IHC) enhances diagnostic accuracy by using targeted antibodies to identify specific proteins, helping distinguish challenging cases such as melanoma, and non-melanoma skin cancers (NMSC) (e.g. poorly differentiated squamous cell carcinoma, Extramammary Paget's disease (EMPD), Merkel cell carcinoma (MCC), etc). While H&E provides general tissue architecture, Mohs surgeons will integrate IHC into their Mohs process to improve:
- Detection of subtle tumor nests that may be missed with H&E.
- Confirmation of difficult cases where H&E results are inconclusive. For example, poorly to moderately differentiated Basal & Squamous Cell Carcinomas.
- Identification of high-risk tumors like melanoma or perineural invasion in SCC.
Some key IHC markers that are used to target proteins unique to certain cancers in Mohs frozen section analysis:
- Melanoma – Markers like MART-1 and SOX10 to provide clear identification. For example, melanocytes blend with surrounding tissue, making melanoma difficult to detect.
- Basal & Squamous Cell Carcinoma – Ber-EP4/EpCAM (BCC) and p40 or CK5/6 (SCC) to confirm diagnosis.
- Extramammary Paget's disease (EMPD) – CK7 to improve accuracy of margin control.
- Merkel Cell Carcinoma – CK20 and synaptophysin ensure accurate detection.
Some additional benefits for IHC integration into Mohs laboratories:
- Reduces false negatives, preventing recurrence.
- Enhances diagnostic confidence for Mohs surgeons.
- Improves patient outcomes with precise tumor identification and minimizing unnecessary re-excisions.
While IHC requires optimized protocols (manual and automated modalities- see simplified flowchart), strict quality control, and efficient turnaround, rapid protocols can integrate seamlessly into Mohs workflows. As technology advances, IHC will continue to refine Mohs surgery, improving accuracy and patient care.
CK7 staining of EMPD Image courtesy of Stacie Eckhout
MART-1 staining of Melanoma
SOX10 staining Normal Skin
CK5 highlighting tumor in an area of inflammation in NMSC
Save the Date: CLIA Webinar
Join us on June 19, 2025 at 8:00 p.m. ET/7:00 p.m. CT for a CLIA Webinar. This presentation will review regulatory standards with the audience, to help participants understand why regulatory standards are in place to ensure the safety, quality, and efficiency within the scope of the clinical laboratory with a focus on Mohs laboratories. One of the key regulatory frameworks in the laboratory setting is The Clinical Laboratory Improvement Amendments (CLIA). Attendees will gain insight into the role of CLIA within a Mohs laboratory and how CLIA focuses on patient safety. The talk will concentrate on quality assurance (QA) and quality control (QC) and their importance in laboratory operations. Additionally, the talk will discuss Competency Assessment as a vital part of ensuring laboratory staff efficiency. Examples of applicable regulatory standards will be given, such as CLIA, and how they are applied in laboratory settings will be discussed to highlight their role in maintaining optimal laboratory operations.
ASMH Members: Included with Membership
Non-Members: $25.00
Keep an eye on your inbox and ASMH social media channels for the link to register.