Skin biopsy Journal of the American Academy of Dermatology

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Presentation transcript:

Skin biopsy Journal of the American Academy of Dermatology Dirk M. Elston, MD, Erik J. Stratman, MD, Stanley J. Miller, MD Journal of the American Academy of Dermatology Volume 74, Issue 1, Pages 1-16 (January 2016) DOI: 10.1016/j.jaad.2015.06.033 Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Biopsy specimens for direct immunofluorescence for suspected bullous pemphigoid should be taken from nonbullous lesional skin or uninvolved perilesional skin within 1 cm of a bulla. Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 An electronic power punch is a good alternative for biopsy specimens obtained from patients with panniculitis, especially in patients with a bleeding diathesis. (Photograph courtesy Howard Pride, MD, Geisinger Medical Center.) Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Biopsy specimens for direct immunofluorescence for suspected chronic cutaneous lupus erythematosus should be taken from an established lesion (>6 months old). Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Biopsy specimens obtained from patients with scarring alopecia should be taken from well-developed lesions, preferably of several months' duration, but that are still active. Fully developed lesions provide a higher diagnostic yield when compared with the advancing border. Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 The Tyler technique involves vertical sectioning of the specimen, followed by transverse sectioning of one half. The 2 resulting half circles are embedded facing one another, fresh cut side down. The HoVert technique involves transverse sectioning of the specimen followed by vertical sectioning of the upper 1-mm portion. Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 Superficial biopsy specimens of basal cell carcinoma may feature a superficial multifocal growth pattern (A) and may fail to show a deeper, more aggressive growth pattern (B). Journal of the American Academy of Dermatology 2016 74, 1-16DOI: (10.1016/j.jaad.2015.06.033) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions