Skin biopsy involves taking a sample from a specific area of the skin for further microscopic examination. A similar procedure is performed in several ways, after which the skin sample is sent for histology.
Indications for
There are no absolute indications for biopsy research. The histological characteristics of most dermatoses are not pathognomonic and can not confirm the diagnosis.
But even if the diagnosis gets a histological confirmation, this will not affect the therapeutic process.
Quite often, if there are doubts about the biopsy, so as not to incur additional costs to the patient, it is more reasonable to send the patient to a dermatological consultation.
Still, the procedure has a number of indications:
- Malignant oncology;
- Definition of the type of benign education;
- For the diagnosis of infections of viral, fungal or bacterial origin;
- Cutaneous tuberculosis;
- Definition of inflammatory lesions;
- To assess the epidermis at the site of removal of tumor formation;
- Lupus;
- Psoriasis;
- Amyloidosis;
- Scleroderma;
- Deep mycosis;
- Darya's disease;
- Periarteritis of the nodular type;
- Reticulosis, etc.
Techniques for skin biopsy
Sampling of bio-samples is carried out by several methods such as puncture, loop, shaving, punch biopsy. In fact, a biopsy is an excision of a small piece of skin or a sample using local anesthesia.
Today, the most commonly used methods are:
- Trepanobiopsy - from the middle of the lesion take a column of biomaterial together with the epidermal layer and subcutaneous tissue. First, the skin in the right place is stretched, then make a puncture with a needle, rotating it in a circle. Then the needle is pulled out, and the resulting column of biomaterial is pulled out with tweezers and cut off. The wound is covered with a band-aid, and if it is more than 3 mm, it is sewn up.
- Shaving - the technique involves obtaining a biopsy by cutting the protruding part of the lesion by means of a blade or a scalpel. The cut after the procedure is treated to avoid bleeding.
- Punch biopsy - is carried out with a special knife tubular form 2-8-millimeter diameter. In appearance it is a hollow cylindrical tube with cutting edges. It is moved deeper into the affected area, rotating for ease of advancement. The resulting sample is a column of tissue, consisting of several layers like subcutaneous tissue, dermis and epidermis. The wound is sewn up.
- Excisional or incisional biopsy - when the entire formation or part of it is excised.
- Loop biopsy - the material is taken up by a specialized loop using a radio-frequency surgical apparatus or coagulator.
- Puncture - involves obtaining a bio sample using a specialized needle and a biopsy syringe or gun. When the desired sample is drawn into the needle and removed from the puncture site.
The obtained bio sample is placed in a formalin solution or a special container and sent to the laboratory for histological and cytological examination.
Preparation of
A biopsy study can be conducted without special training, although sometimes patients need to devote a doctor at some points:
- Tell about a probable pregnancy;
- Presence of drug allergy;
- Bleeding addictions;
- Report on the treatment of anti-inflammatory drugs( such as Prednisolone that distorts results), blood thinning medications( such as warfarin or Aspirin, increasing the risk of bleeding), drugs for immune suppression( after implant transplantation) or for diabetes therapy.
Technique for taking
Depending on the purpose of the study and the site of localization, various techniques for obtaining a biopsy can be used, which are most suitable for a specific clinical situation.
Biopsy of skin lesions
Usually, the biomaterial in the presence of skin lesions is obtained by the operation, during which the desired tissue is cut off.
Bio-samples are taken in different ways, among which the specialist selects the most suitable in each case, taking into account the location of the formation, cosmetic consequences, etc.
Bioptate take:
- Shaving method , when a small cut is made with a scalpel. The resulting wound is simply covered with a bandage, it is not necessary to sew it. In this way, a whole new growth can be removed, or the desired bio-sample can be obtained.
- The incision technique, when the tumor is partially removed and these tissues are examined under a microscope. Such a technique allows for a detailed histological study. After the procedure, the wound needs a suture.
- Puncture technique, when tissue is obtained with a special needle 1-6 mm diameter. Excellent for diagnosing large tumor formations. If the tumor is smaller than the diameter of the needle, then a similar technique is suitable for its removal.
- The total technique assumes complete removal of the formation and its further histological examination. If you suspect a cancer, the edge of the excised area is marked, which in the future will help to easily determine the boundaries of the tumor.
Skin biopsy with histological examination
Histology is considered the main method of examining skin pathologies. From the affected area take a skin sample and send for analysis, which allows to reveal a variety of skin lesions.
The main condition of histological examination - a biopsy should be taken with a layer of fatty subcutaneous tissue.
Usually, excision excision of the skin is used for this. A biopsy is obtained using a scalpel or a biopsy needle. The tissues are then subjected to microscopic examination and immunofluorescent staining.
Results of
Usually the results after a skin biopsy are ready in 4-10 days. They are considered normal if the biopsy is a normal piece of skin, consisting of healthy cells.
Atypical results are observed when fungal or bacterial infectious processes are detected in the bio sample, pathologies like vasculitis, psoriasis, lupus are revealed, cancerous cell structures( melanoma, squamous or basal cell carcinoma) are detected, benign neoplasms( such as nevi, warts and papillomas, keloids andkeratosis, hemangiomas and dermatofibrom, neurofibre, etc.).
Sometimes the research is not reliable. Biopsy results can be affected by several factors:
- NSAID admission;
- Treatment with antifungal medicines;
- Use of corticosteroid creams.
Therefore, it is necessary to warn the doctor beforehand about the presence of such factors.
Complications of
Among the most likely complications, diagnosticians identify:
- Long healing of wound surface;
- Painful discomfort, passing alone in a day or two;
- Bleeding;
- Infection.
The doctor warns the patient about these risks before the procedure, after which the patient signs a special consent for the skin biopsy.
Wound care after the procedure
After receiving a biopsy, there remains a wound requiring appropriate care. In accordance with the size of the wound surface, a sterile dressing may be necessary for several days.
Sometimes, at the sampling site of the bio-sample, slight bleeding is observed. If it does not pass and worries for several days after the procedure, then you need to see a doctor.
After the excision or puncture technique of obtaining a biopsy at the site of the fence, there remains a scar. In open places like face, neck, décolletage, it causes a characteristic discomfort. Such wounds last about 1.5-2 months. If the bio-samples were taken from the limbs, the healing will last a little longer.
Wound care during this period assumes the following actions:
- Before handling or touching the wound, it is essential to wash hands;
- The treatment is carried out with an antiseptic, then it is sealed with a band-aid or a sterile dressing;
- The wound must be kept dry and clean;
- Do not immerse the lesion in water before healing;
- Care is carried out until complete healing or before the removal of stitches.
Usually, when shaving excision pain is not felt and the wound is soon allowed to wet. When puncture obtaining bio-samples, the wound is sutured, so it is forbidden to wet it for 2-3 days. In addition, avoid stretching the skin at the site of the biopsy sampling, as this can provoke bleeding.
Price
Diagnostic examination of skin bio-samples is characterized by a different price range, due to the diagnosis of the proposed pathology and the location of the biopsy sampling.
Skin biopsy in the capital's clinics will cost 830-2780 rubles.
It is better to undergo a biopsy procedure in specialized medical centers and clinics, where doctors' qualifications are 10 times higher than doubtful cosmetology cabinets.