Skin biopsy: Biopsy issues in specific diseases

Abstract

Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

Keywords: Stevens–Johnson syndrome; basal cell carcinoma; bullous diseases; connective tissue diseases and porphyria; cutaneous T-cell lymphoma; dermatofibrosarcoma protuberans; hair disorders; malignant melanoma; neoplasms; panniculitis; primary cutaneous B-cell lymphoma; squamous cell carcinoma; staphylococcal scalded skin syndrome; toxic epidermal necrolysis; vasculitis.