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Biopsy: skin
Introduction
- Skin histopathology is a valuable aid to differential and definitive diagnosis of many skin disorders.
Uses
- Definitive diagnosis of certain skin diseases.
- Categorization of skin disease.
Disadvantages
- Excisional if lesion small enough, or incisional.
- Most animals require sedation.
- Nasal, facial and footpad lesions: may require short-acting general anesthesia.
- Must be obtained early in course of disease before chronic inflammatory changes occur.
- Exercise caution if:
- Bleeding disorders or concurrent medication, eg aspirin or anticoagulants, affecting bleeding.
- Immunosuppressed animals: rare (may be wound healing problem).
- Local anesthesia: injecting lignocaine Lidocaine with adrenaline near extremities and into patients with circulatory disorders (maximum 1ml of 2% lignocaine/5kg body weight).
- Select primary lesions if possible.
Technical problems
- Artifacts may cause difficulty in interpretation.
- Representative tissue must be submitted.
Time required
Preparation
- 5-20 minutes.
Procedure
- 5-20 minutes.
Decision taking
Criteria for choosing test
- Primary lesions.
- Deep lesions.
- Masses or any possible neoplastic lesions.
- Non-healing lesions.
- Conditions failing to respond to therapy (generally within 3 weeks).
- Unusual or atypical dermatoses.
- Conditions suspected which require therapy which may be expensive, of extended duration or hazardous.
- Dermatosis diagnosed by biopsy, eg immune-mediated skin disease .
Stop topical or systemic glucocorticoid therapy 2-4 weeks before biopsy.If secondary bacterial pyoderma Bacterial skin disease: overview, administer course of systemic antibiotic therapy before biopsy.
Risk assessment
- Sedation or general anesthesia: routine checks
- If known bleeding disorder: caution.
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.
- Noxon J O (1995) Diagnostic procedures in feline dermatology. Vet Clin North Am Small Anim Pract 25 (4), 779-99 PubMed.
Other sources of information
- Ihrke P J (1996) Bacterial Skin Disease in the Dog - a Guide to Canine Pyoderma. Veterinary Learning Systems. pp 59-61. (Biopsy technique with special reference to pyoderma.)
- Ogilvie G K & Moore A S (1995) Managing the veterinary cancer patient: A practice manual. Veterinary learning systems pp6-8.
- Moriello K A & Mason I S (1995) Eds Handbook of Small Animal Dermatology. 1st edn. Oxford: Pergamon. pp 31-33. (Step by step procedure with photographs.)
- Muller G H et al (1995) Muller and Kirk's Small Animal Dermatology. 5th edn. Philadelphia: W B Saunders. pp 111-118. (Detailed account.)