Skin Biopsy - Diagnosis using Skin Biopsy

Skin biopsy of erythematous, scaling lesions of dermatomyositis may reveal only mild nonspecific inflammation but sometimes may show changes indistinguishable from those found in SLE, including epidermal atrophy, hydropic degeneration of basal keratinocytes, edema of the upper dermis, and a mild mononuclear cell infiltrate. Performed with local anesthesia, a skin biopsy is performed to obtain microscopic evaluation.

A skin biopsy is the removal from the body of any piece of skin or tumor tissue that is to be sent to a laboratory to be stained and examined under the microscope. A biopsy may be large or small. A biopsy may be an incisional biopsy, i.e., the taking of a piece of a tissue smaller than the skin area about which the doctor is concerned, in order to get an idea of what the process is.

Skin biopsy of acute lesions may show only a sparse dermal infiltrate of mononuclear cells and dermal edema. In some instances, cellular infiltrates around blood vessels and hair follicles are notable, as is hydropic degeneration of basal cells of the epidermis. Skin biopsy reveals thickening of the dermis and homogenization of collagen bundles. Direct immunofluorescence microscopy of lesional skin is usually negative.

Skin biopsy reveals a dense mononuclear cell infiltrate around hair follicles and blood vessels in the superficial dermis, combined with hydropic degeneration of basal cells in the epidermis. Skin biopsy of morphea is indistinguishable from that of scleroderma.

The dermatologist will perform the skin biopsy. You may feel a pushing sensation in the area where the skin biopsy is being performed but there should not be any pain. You should tell the doctor if the procedure is painful during the biopsy.