Skin inflammatory (nontumor)

Author: Cecilia Rosales, M.D. (see Authors page)

Revised: 11 October 2018, last major update August 2010

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Skin AND biopsies [title]

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Table of Contents
Definition / general
Cite this page: Rosales, C. Biopsies. website. Accessed January 22nd, 2019.
Definition / general
  • 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)