Skin biopsy

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Item	Process
Specimen	Punch, shave or excisional skin biopsy. Skin fibroblast culture requires fresh tissue transported in sterile culture medium at room temperature (consult laboratory staff). Fresh tissue from edge of lesion in sterile container for microbiology.
Method	Fresh tissue: for frozen section, immunofluorescence and molecular genetics. Fixed tissue: for light microscopy, immunohistochemistry, electron microscopy (special fixative). Immunofluorescence and/or immunohistochemistry: for diagnosis of bullous lesions, lymphoid neoplasms, Henoch Schoenlein purpura and SLE; microscopy (Gram stain, stains) for Mycobacterium sp; culture for bacteria and fungi; and chemical, cytogenetic or molecular genetic studies on cultured fibroblasts.
Application	Investigation of skin lesions including rashes, bullous lesions, ulcers, tumours. Investigation of some genetic disorders.
Interpretation	Categorisation of inflammatory or infective (eg, atypical myocbacterial) dermatoses, typing of bullous lesions, connective tissue diseases and vasculitis. Categorisation of naevi and other forms of benign neoplasia. Identification of type, grade and stage of malignant tumours. Fibroblast studies may allow precise diagnosis of specific genetic disorders.
Reference	Rapini RP. In: Farmer ER and Hood AF eds. Pathology of the Skin. 2nd ed. McGraw-Hill 2002.