During outpatient or inpatient visits, the attending physician often suggests cutting a small piece of skin for examination, which many patients often do not understand and are filled with fear. We hope to unravel the mystery of dermatopathological examination through the following introduction.
As we all know, there are many different kinds of skin diseases, and the rash is very variable, some lacking in specificity, so it is difficult to make an accurate diagnosis with the naked eye alone, and often requires the help of relevant laboratory tests and biopsies to make a diagnosis. Dermatopathological examination is a common examination technique in dermatology and is regarded as the gold standard for dermatological diagnosis. It occupies an irreplaceable position in the diagnosis of difficult skin diseases and in the differentiation of benign and malignant skin diseases, and also plays a very important role in the judgment of the occurrence, development and prognosis of diseases. The importance of skin histopathology, which has favorable conditions not found in any other organs of the human body, and the increasing objective demand, has become an indispensable part of the dermatologists’ daily treatment work. However, compared to European and American countries, the prevalence of dermatopathology in China is low.
What is the situation of the process of dermatopathology examination? When the patient is seen and the doctor recommends the test, a representative lesion is first selected and then a small outpatient operating room is used to remove a small piece of skin from the lesion using skin drilling or minor surgery under local anesthesia and then sutured, called a skin biopsy, which can be done in a dermatology clinic and generally takes 15-30 minutes, making the procedure relatively simple and low-risk. The specimen is sent to the dermatopathology diagnostic room, and after a series of work such as fixation and staining, the dermatopathologist observes the changes under the microscope and makes the corresponding diagnosis or gives a recommendation, and the report is usually issued in about 7 days. When the minor outpatient surgery is completed, the patient needs to return to the clinic or clinic on a regular basis to have the wound cleaned and changed on a regular basis, and the stitch removal time will be decided according to different parts.
Skin pathology examination has important value for the diagnosis of skin diseases, including the following types of diseases: ① tumors, such as malignant melanoma, squamous cell carcinoma and basal cell carcinoma; ② inflammatory skin diseases with characteristic manifestations, such as lichen planus, tuberculosis, leprosy, certain deep fungi, etc.; ③ metabolic skin diseases, such as skin amyloidosis, pigmented purpura dermatosis, gout, etc.; ④ autoimmune skin diseases Such as aspergillosis, herpetiform aspergillosis, etc. Although some skin diseases without characteristic tissue changes cannot be diagnosed directly, they still have the value of reference or exclusion of other diseases. Therefore, at present, the dermatology department advocates actively carrying out skin pathology examination under the premise of mastering the indications and close clinical relationship, which can not only improve the clinician’s diagnosis and treatment level, but also enable the patient to get a clear diagnosis and formulate an effective treatment plan to achieve satisfactory treatment results.
Through the above introduction, I hope to have an understanding of skin biopsy and pathological examination, so that when the next visit, the doctor tells you that you need to do this examination, you will not feel afraid because of it.
This article is authorized by Dr. Ruzeng Xue.