Skin-nontumor / Clinical Dermatology
Reviewer: Cecilia Rosales, M.D., Baylor College (see Reviewers page)
Revised: 24 August 2011, last major update August 2010
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.
● If possible, biopsy a primary lesion
● Proper selection of anatomical site and best lesion to perform a biopsy are very important (An Bras Dermatol 2009;84:507)
● Biopsy characteristic areas in their diagnostic stage, not ruptured bullae, secondarily infected / scratched areas or involuting lesions
● Some lesions are best diagnosed early (blisters, vasculitis) or late (psoriasis, discoid lupus erythematosus, lichen planus)
● Punch biopsy of nearby normal skin may be helpful, particularly if changes in abnormal areas are quantitative (hyperkeratosis, acanthosis, etc.)
● Must recognize that biopsy captures histopathology only at one point in time in evolution of a lesion
● For inflammatory lesions, biopsy should correlate with clinical differential diagnosis
● For widespread dermatoses, avoid biopsying lesions on the legs; at this site, but not elsewhere, the biopsy heals slowly and lesions are often hemorrhagic
● For alopecias, biopsy the border of active lesions, but if evaluation for hair regrowth is needed, biopsy the most advanced area
● For metabolic abnormalities, electron microscopy of axillary skin biopsy may be helpful, although results may be nonspecific (Hum Pathol 2001;32:649)
End of Skin-nontumor / Clinical Dermatology > General > Biopsies
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