Clinical Case Database / Category: Patient Management
The pigmented skin lesion: the role of biopsy in dermatology
Publication details
Dr J I O Abiola MBBS, BSc, Dr B A Esdaile MBBS, BSc, MRCP, Dr R Ratnavel MA, MBBS, DM, FRCP
Foundation Years Journal, volume 4, issue 10, p.5 (123Doc Education, London, January 2011)
Abstract
Diagnostic skin biopsies play an essential role in dermatology and provide information that can be correlated with the clinical impression to give a diagnosis. We discuss the presentation and management of two patients with pigmented skin lesions in order to highlight some important principles of skin biopsy. The biopsy strategies varied in each case due to the clinical impression, the size and site of the lesion. Excisional biopsy is the method of choice for clinically suspicious lesions. Other methods such as incisional biopsy, punch biopsy or curettage may be used for benign or pre-malignant lesions depending on lesion characteristics and patient preference.
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Authors
Dr J I O Abiola MBBS, BSc
Foundation doctor
Buckinghamshire Hospitals NHS Trust
Dr B A Esdaile MBBS, BSc, MRCP
Dermatology Registrar
Buckinghamshire Hospitals NHS Trust
Dr R Ratnavel MA, MBBS, DM, FRCP
Consultant dermatologist
Buckinghamshire Hospitals NHS Trust
References
1. Foundation Year Programme Curriculum: core competences and skills http://www.foundationprogramme.nhs.uk/pages/home
2. Emmett AJJ and O'Rourke MGE (1991) Examination and recording of the skin tumour. In: Emmett AJJ and O'Rourke MGE (eds). Malignant Skin tumours, 2nd edition. London: Churchill Livingstone.
3. Davis NC et al. (1991) Malignant Melanoma. In Emmett AJJ and O'Rourke MGE (eds). Malignant Skin tumours, 2nd edition. London: Churchill Livingstone.
4. Rajpar SF, Marsden JR. (2006) Imiquimod in the treatment of lentigo maligna. British Journal Dermatology. 155(4):653–656.
5. Improving outcomes for people with skin tumours including melanoma http://guidance.nice.org.uk/CSGSTIM/Guidance
6. Olbricht S. (2008) Biopsy Techniques and Basic Excision. In: Bolognia JL, Jorizzo JL and Rapini RP (eds). Dermatology, 2 volume set, 2nd edition . St Louis, MO: Mosby.
7. Lewis KG, Dufresne RG Jr. (2008) A meta-analysis of complications attributed to anticoagulation among patients following cutaneous surgery. Dermatol Surg. 34(2):160–164; discussion 164–165. Epub 2007 Dec 17.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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