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Biopsy Techniques

Biopsy Techniques. Jeffrey C. Page, DPM Arizona School of Podiatric Medicine Midwestern University. Importance of Timely Biopsy. Is One Enough?. Incisional Excisional Nail. Shave Curettage Punch Excision. Biopsies. Instrumentation. Incisional Biopsy.

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Biopsy Techniques

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  1. Biopsy Techniques Jeffrey C. Page, DPM Arizona School of Podiatric Medicine Midwestern University

  2. Importance of Timely Biopsy

  3. Is One Enough?

  4. Incisional Excisional Nail Shave Curettage Punch Excision Biopsies

  5. Instrumentation

  6. Incisional Biopsy • Removes only a portion of the mass • Sample the center of the mass • When biopsying an ulcer, include normal tissue, border, and ulcer bed • Not recommended for melanoma Pyoderma Gangrenosum Psoriatic Plaque

  7. Excisional Biopsy • Pick fresh lesions that are fully developed • Remove the entire lesion • Must have a clear border of normal tissue • Needs pathologic analysis to confirm that borders are clear Squamous Cell Basal Cell

  8. Shave Technique • Used most often with benign lesions • Best with raised lesions • Infiltration beneath a lesion can lift mass and make it easier to shave. • May be incisional or excisional

  9. Punch Technique • May be incisional or excisional • 4mm or greater may require primary closure • Clean with alchohol, sterile technique not required • Anesthetize with local containing epi • Apply pressure or Monsel’s solution to stop bleeding

  10. Punch Technique

  11. Curettage Technique • An excochleation technique • “Scoops” the lesion intact from the surrounding tissue • Useful for verrucae and porokeratoses

  12. Blunt Curettage

  13. Electrofulguration & Electrocautery

  14. Mohs Surgery

  15. Structure and Function of the Nail

  16. Structure and Function of the Nail

  17. The Nail Unit

  18. Pigmented Longitudinal Streak

  19. Glomus Tumor of the Matrix

  20. Mucoid Cyst of Proximal Nail Fold

  21. Excision of Mucoid Cyst

  22. Healing of Mucoid Cyst Excision

  23. Pigmented lesion in the Matrix

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