Information on the skin biopsy

The timing of the biopsy

Selecting the site of the biopsy in partial biopsies

Biopsies lend themselves best to a confident assessment when the lesion is recorded complete. A complete biopsy, however, is not always possible. In the case of neoplasias, the site for a biopsy should be chosen so that at least a small section of non-diseased skin is recorded. This provides the histopathologist with an opportunity to assess the extent of the tumour, which may be critical for distinguishing benign from malign neoplasias. In cases of inflammatory dermatoses, on the other hand, the inclusion of healthy skin in inadvisable.16 Unlike most neoplastic changes, the edges of an inflammatory growth are no longer visible when dissecting and embedding at the laboratory. If healthy skin is included in the biopsy, it not infrequently happens that only this skin is cut into first in the histopathological preparation, while the really interesting growth can be assessed only inadequately, or not at all. In cases of inflammatory dermatoses, the biopsy should be carried out at the centre of the most severely-inflamed area. When there are tubercles or plaques, these are usually at the centre of the lesion, in the case of anular foci, the inflamed border. Bei entzündlichen Alopezien sollte die Stelle mit dem am stärksten ausgeprägten Erythem gewählt werden, da Biopsien aus vernarbten Arealen nur noch Restveränderungen zeigen, die keine spezifische Diagnose zulassen. Normale Haut sollte nur dann in die Biopsie mit einbezogen werden, wenn der Vergleich von betroffener und nicht veränderter Haut für die Diagnose entscheidend ist, wie dies vor allem für Atrophodermien und die Vitiligo gilt. Eine Markierung von betroffener und unbefallener Haut am Präparat ist in solchen Fällen wichtig für die korrekte Orientierung des Gewebestückes im Labor.

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