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Pediatric Dermatology Mar 2018Punch and shave biopsies are important dermatologic procedures in the inpatient setting but have a risk of wound infection. Data on the incidence of infection in this...
Punch and shave biopsies are important dermatologic procedures in the inpatient setting but have a risk of wound infection. Data on the incidence of infection in this setting are limited and conflicting. This retrospective study of 127 pediatric inpatients at two tertiary care centers who underwent biopsy demonstrated a low overall risk of infection (n = 1, 0.8%). Twenty-five (19.7%) were neutropenic, and 51 (40.2%) were not taking systemic antibiotics at the time of biopsy; none of these patients developed a wound infection. The overall low rate of infection should reassure physicians who are balancing the risks and benefits of performing a skin biopsy in children in the inpatient setting and suggests that physicians should not defer clinically indicated biopsies because of concern about infection.
Topics: Adolescent; Biopsy; Child; Child, Preschool; Female; Humans; Incidence; Infant; Inpatients; Male; Registries; Retrospective Studies; Risk Factors; Skin; Wound Infection; Young Adult
PubMed: 29314297
DOI: 10.1111/pde.13377 -
The British Journal of Dermatology Jan 2009Diagnostic biopsy of basal cell carcinoma and other skin tumours may be necessary prior to definitive treatment.
BACKGROUND
Diagnostic biopsy of basal cell carcinoma and other skin tumours may be necessary prior to definitive treatment.
OBJECTIVES
To assess whether shave biopsy sampling of tumours without local anaesthetic can provide adequate tissue to make an accurate histological diagnosis, and to determine whether any discomfort is associated with the technique.
METHODS
One hundred and nine lesions from 99 patients were sampled by shave biopsy without local anaesthetic. Any discomfort associated with the procedure, and the adequacy of the histological specimen, were documented. The pathology diagnosis was also compared against the clinically suspected diagnosis.
RESULTS
In 108 of the 109 lesions sampled, sufficient tissue was obtained to make an accurate histological diagnosis. In only six of the 109 procedures was any discomfort reported and in all cases this was rated as minor. A high correlation was found between histological diagnosis and initial clinical suspicion.
CONCLUSIONS
Shave biopsy without local anaesthetic is a simple, relatively pain-free method of obtaining tissue samples for histological diagnosis in appropriate tumours.
Topics: Anesthesia, Local; Biopsy; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Female; Humans; Male; Pain; Pain Measurement; Skin; Skin Neoplasms; Treatment Outcome
PubMed: 18795923
DOI: 10.1111/j.1365-2133.2008.08829.x -
Dermatologic Surgery : Official... Apr 2017Shave skin biopsies are essential procedures wherein physicians diagnose dermatologic lesions. The protocol for skin biopsies entails a lidocaine/epinephrine injection.... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Shave skin biopsies are essential procedures wherein physicians diagnose dermatologic lesions. The protocol for skin biopsies entails a lidocaine/epinephrine injection. This study suggests an alternative, novel method of performing a shave biopsy that avoids pain, needles, and injectable anesthesia, termed the Ram Relaxation Technique (RRT).
OBJECTIVE
To present a new technique that physicians may chose to form when faced with dermatological biopsies that are painless and needle free.
PATIENTS AND METHODS
Randomly selected, patients were presented to the authors' offices with abnormal skin lesions that required a shave biopsy. The patients were offered the choice of having an anesthetic injection (1% lidocaine, 1:100,000 epinephrine) or the alternative method (RRT) before the biopsy. Twenty patients (n = 20, 10 men, 10 women) chose the alternative method (RRT) and were the focus of this study. These patients who chose RRT were asked to scale their pain on a scale of 0 to 10 (0 = no pain, 1-3 = mild, 4-6 = moderate, and 7-10 = severe pain).
RESULTS
Fourteen of the 20 patients stated that they experienced no pain (0), 5 experienced mild pain, and 1 patient experienced moderate pain.
CONCLUSION
This study demonstrates an alternative and nearly pain-free method for superficial shave biopsies of the skin for certain patients in the appropriate clinical setting with the appropriate, superficial papule lesions. Dermis lesions, melanocytic lesions, and macular lesions are not ideal candidates given the risk for misdiagnosis, and more pain, respectively.
Topics: Anesthesia, Local; Biopsy; Female; Humans; Male; Needles; Pain; Pain Measurement; Relaxation; Skin
PubMed: 28005621
DOI: 10.1097/DSS.0000000000000999 -
The Journal of Family Practice Mar 2021It took a dermatoscopic examination followed by an e-consultation and shave biopsy to arrive at the diagnosis.
It took a dermatoscopic examination followed by an e-consultation and shave biopsy to arrive at the diagnosis.
Topics: Adenocarcinoma, Sebaceous; Biopsy; Diagnosis, Differential; Eyebrows; Female; Humans; Middle Aged; Skin Neoplasms
PubMed: 33760907
DOI: 10.12788/jfp.0163 -
Annals of Surgical Oncology Oct 2021
Topics: Biopsy; Humans; Melanoma; Neoplasm Staging
PubMed: 33797001
DOI: 10.1245/s10434-021-09935-7 -
The Australasian Journal of Dermatology Feb 2021
Topics: Biopsy; Humans; Melanoma; Skin Neoplasms
PubMed: 32671817
DOI: 10.1111/ajd.13389 -
Journal of the American Academy of... Apr 2002
Topics: Biopsy; Carcinoma, Basal Cell; Humans; Mohs Surgery; Skin Neoplasms
PubMed: 11907530
DOI: 10.1067/mjd.2002.119199 -
Postgraduate Medicine Dec 1988The shave biopsy is the ideal diagnostic and therapeutic tool for the treatment of discrete superficial skin lesions. It is safe, simple to perform, and economical....
The shave biopsy is the ideal diagnostic and therapeutic tool for the treatment of discrete superficial skin lesions. It is safe, simple to perform, and economical. Punch or excisional biopsy is appropriate for rashes and lesions involving the deeper dermis and subcutis. Pigmented lesions should be approached with respect; many can be excised with shave biopsy, but any suspected of being malignant melanoma should be evaluated by a cancer specialist.
Topics: Biopsy; Carcinoma, Basal Cell; Humans; Preoperative Care; Skin Diseases; Skin Neoplasms; Warts
PubMed: 3194325
DOI: 10.1080/00325481.1988.11700518 -
Annals of Surgical Oncology Dec 2021
Meta-Analysis
Base Transection with Shaves: An Avoidable Shortcoming : Reply to Impact of Shave Biopsy on Diagnosis and Management of Cutaneous Melanoma: A Systematic Review and Meta-analysis.
Topics: Biopsy; Humans; Melanoma; Sentinel Lymph Node Biopsy; Skin; Skin Neoplasms
PubMed: 34028635
DOI: 10.1245/s10434-021-10180-1 -
Seminars in Cutaneous Medicine and... Mar 2009Tumors of the nail unit may be difficult to diagnose because of the screening effect of the nail plate. In longitudinal melanonychia, several new promising techniques... (Review)
Review
Tumors of the nail unit may be difficult to diagnose because of the screening effect of the nail plate. In longitudinal melanonychia, several new promising techniques assist with early diagnosis of melanoma (in vivo matrix dermoscopy and immunohistochemistry) as well as sparing as much of the healthy tissues as is possible (shave biopsy technique). Diagnosing nail disorders is in some instances difficult both for the clinician and the pathologist. New tools such as polymerase chain reaction have been proposed for onychomycosis, which accounts for more than half of nail conditions, will allow quick and accurate diagnosis. However, polymerase chain reaction analysis remains expensive and is not routinely used by clinicians. Scoring nail dystrophy by clinical observation remains very subjective; therefore, severity indexes have been proposed. Another emerging noninvasive technique is forensic analysis of nail clippings for detection of drug intake and abuse, as well as exposure to environmental pollution.
Topics: Arthrodermataceae; Forensic Medicine; Humans; Nail Diseases; Nails; Pigmentation; Severity of Illness Index; Skin Neoplasms; Substance Abuse Detection; Ultrasonography
PubMed: 19341942
DOI: 10.1016/j.sder.2008.12.007