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Skin biopsy

ISSN 2398-2993


Synonym(s): Dermatology

Introduction

Introduction

  • Skin histopathology is a valuable aid to differential and definitive diagnosis of many skin disorders.
  • Biopsies can be used for culture and sensitivity of deeper lesions.

Uses

Uses

  • Definitive diagnosis of certain skin diseases.
  • Categorization of skin disease.
  • Exclusion of some diseases.

Punch biopsy

  • For small samples of generalized or widespread lesions, such as:
  1. Demodicosis.
  2. Sarcoptic mange. Mites: overview
  3. Dermatophilosis.
  4. Dermatophytosis. Ringworm
  5. Onchocerciasis Onchocerca spp.
  6. Staphylococcal disease. Staph spp
  7. Immune-mediated skin conditions.
  8. Evaluation of urticaria/angioedema Urticaria and angioedema.
  9. Photosensitivity Photosensitization.

Excisional biopsy

Advantages
  • Simple technique.
  • In many cases will confirm or indicate a clear cut diagnosis.
Disadvantages
  • May not yield definitive diagnosis.
  • Chronic inflammatory changes and self-excoriation mask pathologic changes.
  • Sutures, dehiscence.
  • Head and foot lesions may require sedation Sedating cattle.
  • Must be obtained early in course of disease before chronic inflammatory changes occur.
  • Local anesthesia Local anesthesia - overview.

Technical problems

  • Consult pathologist if in doubt as to specimen/fixative required.
  • Provide pathologist with as much clinical information as possible.
  • Artifacts may cause difficulty in interpretation.
  • Representative tissue must be submitted.

Alternative techniques

Time required

Preparation

  • 5-20 mins.

Procedure

  • 5-20 mins.

Decision taking

Situations in which biopsy is indicated

  • Deep lesions, especially if infectious organisms are suspected, eg atypical mycobacteria.
  • Masses or any possible neoplastic lesions.All neoplastic lesions in cattle must be reported to DEFRA in the UK except papillomata, hemangiomata and hemangiosarcomata.
  • Persistently ulcerated lesions.
  • Conditions failing to respond to therapy (generally within 3 weeks).
  • Unusual or atypical dermatoses.
  • Dermatosis diagnosed by biopsy, eg immune-mediated skin disease.

Risk assessment

Requirements

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Preparation

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Technique

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Littlewood J D (1997) Diagnostic procedures in equine skin disease. Equine Vet Educ 9,174-176.
  • Hahn R A (1984) Skin biopsy in horses. Mod Vet Pract 65 (2), 122 .

Other sources of information

  • Waine K, Busin V & Strugnell B (2019) Getting the Most out of On-Farm Post-Mortems: A Guide for Veterinary Surgeons. AHDB, UK. Website: https://ahdb.org.uk.
  • Moriello K A & Mason I S (1995) Eds Handbook of Small Animal Dermatology. Pergamon, UK. pp 31-33.
  • Muller G H et al (1995) Muller and Kirk's Small Animal Dermatology. 5th edn. W B Saunders, USA. pp 111-118.