Skin Biopsy

    Dirk M. Elston, Erik J. Stratman, Stanley J. Miller
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    TLDR Correct skin biopsy techniques are crucial to avoid misdiagnosis of skin diseases.
    In the 2016 article, the authors provided comprehensive guidelines for skin biopsy procedures to ensure accurate diagnosis of various skin diseases. They stressed the importance of correct site selection and biopsy technique, noting that errors can lead to misdiagnosis. For autoimmune bullous diseases, direct immunofluorescence (DIF) was found to be more sensitive than other tests, with a sensitivity of 90.8% for DIF compared to 76% for indirect immunofluorescence (IIF) and 59-73% for enzyme-linked immunosorbent assay (ELISA). The article recommended specific biopsy techniques and handling for different conditions, such as using Michel or Zeus media for DIF specimens, and provided detailed advice for conditions like vasculitis, panniculitis, connective tissue diseases, and various neoplasms. For melanoma, complete excisional biopsy was recommended for accurate diagnosis and staging, while for other conditions like lentigo maligna and dermatofibrosarcoma protuberans, specific types of biopsies were suggested to maximize diagnostic yield. The document underscored the critical role of proper biopsy technique and specimen handling in avoiding diagnostic errors.
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