Patient # (we will fill in for you) Presented by Dr. (Fill in your name) Date of Meeting: Notes: 1. Do not put patient identifying information in this powerpoint. 2. Please review the referring physician and patient instructions on the CDS website 3. Email this presentation to eileen.axibal@ucdenver.edu or ramin.fathi@ucdenver.edu by the Wednesday before the meeting

Case History and Exam History plus clinical skin exam findings

Clinical photographs Please provide non-identifying clinical photographs if available

Histopathology results If a skin biopsy was performed, at a minimum please fill in the microscopic description and histopathological diagnosis Ideally, attach photomicrographs of biopsy results if available If your pathology was read by CU Dermatopathology, you may do the following to obtain photomicrographs of your histopathology slides. Email Ekama Carlson at eileen.axibal@ucdenver.edu or ramin.fathi@ucdenver.edu with the patient’s name, date of birth, date of biopsy, and Accession or consultation number. This should be done no later than the Tuesday before the meeting. For pathology results read outside of CU dermpath or the University of Colorado, you may contact Nancy Jackson at nancy.jackson@ucdenver.edu. You will need to physically mail her your pathology slides by the Tuesday before the meeting. She will obtain photographs of your slides. The photomicrographs will be added to your presentation and will be displayed at the meeting for discussion

Additional Workup Optional slide, to add results of important labs and/or imaging

Clinical dilemma Please provide your reason for presenting this case. For example, a diagnostic dilemma, therapeutic challenge, or an interesting/unusual case for further discussion and teaching purpose