Medical manipulations in many patients cause panic. They do not understand the terms and the essence of the procedure is unclear. Some even refuse the necessary analyzes, guided by the opinion of homegrown expert neighbors or falling under the influence of stereotypes. But all you have to do is talk to your doctor and ask for a more detailed explanation of the purpose of the appointment. For example, if a patient is offered a skin biopsy, then he should understand that this procedure is prescribed to clarify the diagnosis and to be able to overcome the disease at an early stage.
Skin biopsy - what is it?
A biopsy is a diagnostic procedure in which a piece of living material is taken to further study its cellular composition. Accordingly, a skin biopsy is an excision for examining a piece of skin.
Material for research can be obtained in several ways:
- shaving;
- trepanobiopsy;
- excise.
The choice of method depends on the suspected disease, but in all cases the procedure is performed with a sterile, most often disposable instrument.
Indications for a skin biopsy
Histological examination of biopsy material (biopsy) can be prescribed in the following cases:
- in the diagnosis of bacterial, fungal, viral diseases;
- to determine benign formations;
- to clarify the malignancy;
- to verify the result after removal of the tumor;
- with suspected lupus;
- with suspected tuberculosis of the skin;
- with psoriatic plaques;
- with scleroderma, amyloidosis, reticulosis;
- in the presence of deep mycosis;
- with a disease of periarteritis nodosa;
- for diagnosing Darier’s disease ;
- as a treatment control.
The maximum number of appointments is the detection of cancer. Noticing a change in pigmentation or worsening healing of the integument, the doctor prefers to prescribe a biopsy to be able to conduct treatment at an early stage of development.
Who makes the appointment?
Skin diseases should be consulted by a dermatologist. If the problem is not obvious, but the patient feels discomfort, then he should consult a therapist. After examination, the diagnostic therapist will refer you to the right specialist. He will tell you where to do a skin biopsy.
What instrument is biopsy performed?
As already mentioned, there are several methods by which a biopsy is performed. Depending on this, the necessary equipment and tools are selected. In most cases, this is an individual kit containing a cannula with a hole, a probe and a movable tube with a protrusion to hold a tissue sample.
A puncture biopsy is performed with a needle of the required diameter. It can be a special thin syringe, an automatic system with a spring mechanism or a vacuum needle.
In many cases, a skin biopsy is performed by curettage. In this case, the instrument is an annular curette or a surgical spoon. These tools vary in diameter on the gripping surface.
Methodology Skin biopsy
A biopsy is performed with a scalpel or medical blade. In this case, a surface cut is performed at the site of thickening. The cut off protruding part of the pathological neoplasm is placed in a container with a formalin solution. And the manipulation site is covered with a sterile cloth. The procedure, as in other cases, is performed under local anesthesia.
Trepanobiopsy
In this case, a histological examination of the biopsy material taken from the center of the affected area is performed. A column of skin and subcutaneous adipose tissue is pierced by a trepanation needle, rotated and removed. Then it is picked up with tweezers and cut at the required level. A sterile patch is applied to the wound surface not exceeding 3 mm. With a larger diameter, the wound is sutured.
Excisional biopsy
By this method, a lesion with an adjacent healthy area of the skin is excised. The method is effective for detecting malignant tumors. The remaining wound is covered with a sterile napkin, but if the wound site is large, then it is sutured or covered with a skin graft.
An individual skin biopsy instrument is not reused. All dressings should be sterile. The analysis result is ready in 1-4 weeks. The term depends on the complexity of processing the biopsy.
Psoriasis biopsy
Many patients believe that psoriasis can be diagnosed without analysis by its characteristic appearance. However, a skin biopsy for psoriasis is necessary to rule out other pathologies. In severe cases of the process, Reethe's bodies are present in the biopsy, which are a manifestation of histological immaturity and a thickening of the keratinocyte layer.
With the removal of material for research, spot bleeding is noticeable under the plaque. This is evidence of pathology of vascular permeability at the site of the lesion. Additionally, this allows the detection of accelerated angiogenesis.
Study preparation
Complex preparation for a skin biopsy is not required. Before the procedure, the doctor should be aware of the anti-inflammatory drugs taken, allergic reactions and bleeding tendencies. Women need to warn their doctor about pregnancy.
Recovery after the procedure
You can only touch the site where the sample was taken with your hands thoroughly washed with soap. A bandage or other surgical material is removed one day after the manipulation.
For washing the wound, soap is used without dyes or flavorings. After washing, petroleum jelly or bactericidal ointment is applied to the wound surface. Repeated dressing of the wound is performed as prescribed by the doctor. If there were no additional instructions, then a sterile napkin or dressing should be applied if the wound is located in places that are rubbed with clothing. The place where the skin biopsy was performed, it is necessary to moisten with special ointments several times a day. This will avoid the appearance of a scab.
If the biopsy trace turns red or swollen, then you should consult a doctor. This may be a sign of infection.
For at least a week after the procedure, limit your intake of products with vitamin E, do not drink alcohol, do not take aspirin and ibuprofen. Violation of this requirement can cause bleeding.