High-yield biopsy technique for subepidermal blisters.
Dermatologists often perform 2 biopsies in patients with widespread tense blisters: one for light microscopy and another for direct immunofluorescence (DIF). Biopsy techniques recommended for blistering diseases with tense blisters are discussed, and illustrations demonstrate an alternative approach utilizing a single punch biopsy. A single punch biopsy is more cost effective and provides the same diagnostic information as the standard 2-biopsy approach for subepidermal blisters plus additional salt-split skin-like diagnostic information. A limitation for bisecting the single punch biopsy specimen is a potential complete separation of the epidermis from the dermis. The single punch biopsy technique is a simple cost-effective method for obtaining necessary diagnostic information when sampling tense blisters in patients with blistering diseases.
Mark A
MA
Braswell
Nancye K
NK
McCowan
Jennifer S
JS
Schulmeier
Division of Dermatology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA. rbrodell@umc.edu.
Robert T
RT
Brodell
D001706:Biopsy / Q000379:methods*; D001768:Blister / Q000473:pathology*; D003874:Dermatitis Herpetiformis / Q000473:pathology; D017449:Dermatitis, Allergic Contact / Q000473:pathology; D016107:Epidermolysis Bullosa Acquisita / Q000473:pathology; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods; D006801:Humans; D010391:Pemphigoid, Bullous / Q000473:pathology; D017119:Porphyria Cutanea Tarda / Q000473:pathology; D013048:Specimen Handling / Q000379:methods*