American Society of Dermatopathology

View all recommendations from this society

October 17, 2018

Do not perform the t(17;22) fluorescence in situ hybridization (FISH) assay on cases of dermatofibrosarcoma protuberans in situations where the translocation has already been detected by another testing modality.

Various testing modalities can be used to detect the t(17;22) translocation in dermatofibrosarcoma protuberans, with each being able to provide confirmation of the presence of the translocation.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Society of Dermatopathology (ASDP) is committed to improving the quality of lives by continually advancing the theory and practice of dermatopathology. In 2015, under the vision of the then Society President, Dr. Dirk Elston, the Appropriate Use Criteria (AUC) Task Force was created to help guide dermatopathologists and inform their clinical colleagues in their use of ancillary studies performed in dermatopathology in specific clinical scenarios with overarching goal of producing high quality care, lowering costs and ensuring efficient use of laboratory resources. The Task Force identified ancillary studies performed in dermatopathology encompassing four broad areas in which AUC could be developed. These include: lymphoproliferative, melanocytic, soft tissue, and other, which includes entities that do not fit into one of the aforementioned groups. Using the methodology developed by RAND/ UCLA, which combines best scientific evidence with expert opinion to develop patient-centered guidelines (appropriateness ratings), the Task Force explored 12 ancillary studies used in dermatopathology and 211 clinical scenarios that are commonly encountered in dermatopathology. The Task Force was transitioned to a standing Committee in 2017, and along with working on dissemination of the developed AUC, the committee identified areas, which have a potential for misuse and are supported by evidence, which could be converted into recommendations for the Choosing Wisely Campaign. The recommended list was reviewed and approved by the ASDP Ethics Committee and Board of Directors.


Linos K, Kozel JA, Yadira Hurley M, Andea AA. Review of the medical literature and assessment of current utilization patterns regarding the use two common fluorescence in situ hybridization assays in the diagnosis of dermatofibrosarcomaprotuberans and clear cell sarcoma. J Cutan Pathol. 2018 Aug 28. [Epub ahead of print]

Vidal CI, Armbrect EA, Andea AA, et al. Appropriate Use Criteria in Dermatopathology: Initial Recommendations from the American Society of Dermatopathology. J Cutan Pathol. 2018 Aug;45(8):563-580 (full version) and J Am Acad Dermatol. 2018 Apr 21. [Epub ahead of print] (abbreviated version) [co-published].