Limitations of Dermatopathology: Muir-Torre Syndrome as an Example [editorial]

In the current state of the US economy and health care system, dermatologists need to be ever vigilant in ensuring that the tests we order are relevant to disease diagnosis, management, and/or treatment. Several articles in the literature have suggested that routine immunohistochemical staining of sebaceous neoplasms is an important screening tool for Muir-Torre syndrome. Although immunohistochemistry can play a role in evaluating for MuirTorre syndrome in certain situations, testing is not a requisite for the diagnosis of this disease; rather it is a clinical diagnosis based on the presence of at least 1 sebaceous neoplasm and a personal history of internal malignancy. This definition of the syndrome obviates the need for immunohistochemical testing in patients who meet these 2 criteria; clinical history is sufficient in these cases.