title: Skin biopsy: Biopsy issues in specific diseases.
abstract: Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.
authors.affiliation: Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Elston
authors.affiliation: Department of Dermatology, The Marshfield Clinic, Marshfield, Wisconsin. Electronic address: stratman.erik@marshfieldclinic.org.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Stratman
authors.affiliation: Department of Dermatology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Miller
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D004502:Education, Medical, Continuing; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006201:Hair Diseases / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D015434:Panniculitis / Q000473:pathology; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology; D013206:Staphylococcal Scalded Skin Syndrome / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000473:pathology; D014657:Vasculitis / Q000473:pathology
keywords: Stevens–Johnson syndrome; basal cell carcinoma; bullous diseases; connective tissue diseases and porphyria; cutaneous T-cell lymphoma; dermatofibrosarcoma protuberans; hair disorders; malignant melanoma; neoplasms; panniculitis; primary cutaneous B-cell lymphoma; squamous cell carcinoma; staphylococcal scalded skin syndrome; toxic epidermal necrolysis; vasculitis