Anyone had a Skin Biopsy?

adam_h · 28th May 2008, 10:36 AM

Hi all,

Just wondering if anyone has had a skin biopsy taken from their face before? It seems it can test for bacterial or fungal infections and various other abnormalities. I presume it can also measure the thickness of the epidermis, which may be useful. I seem to have a mixture of seb derm, rosacea and acne vulgaris and any confirmation on the makeup of my skin composition would seem to be valuable.

- If you have had a skin biopsy, was it a 'shave biopsy?'
- Did you experience any scarring or was it fairly non-evasive?
- Was it worthwhile?

bd eyes · 28th May 2008, 01:27 PM

Hi Adam,

I had a punch biopsy done. I did not want it done on my nose as I knew it would mark. I had the biopsy done at the back of my neck instead.

Here are the results take from my skin biopsy sent to my doctor.

"The biopsy showed prominent sebaceous glands and mild chronic inflammation.
The pathologist reported this as not diagnostic, but may represent rosacea.
Immunoflourescence of a skin biopsy sample revealed a faint linear band of 1gC,
but was negative for IfM, IgA and C3. In this clinical setting I don't think this is
significant."

I am not quite sure what this means, does anyone out there know? The below extract was sent to me after I saw a team of dermatologists in the acute service division two years later after the initial biopsy.
.
"The symptoms you are experiencing do not represent any disease in the skin."

So effectively, two full years of waiting and seeing more consultants together with many more treatments merely resulted in my symptoms getting worse. Now the cartilage at the side of my nose is damaged.. At one point, I couldn't even get through the day with nose burningm, stomach problems and excruciating eye pain. In my case, the biopsy was futile. I am now slowly progressing, but that is only down to my own determination, hard work and research. You know your own face and if something is wrong.

Hope this helps. Good luck.
bd eyes

J-Mill · 28th May 2008, 02:58 PM

Biopsy is not a particularly valuable tool in Rosacea as there is no way of testing for Rosacea or many other skin conditions for that matter. As the rpevious poster's biopsy showed you often end up with little significant data to go on. I also had a biopsy on my scalp (punch) which simply showed inflammation, non-scarring.

If you want to be tested for dermodex mites this might have some merit and a simple skin scraping will do (very non-invasive). It may be what you have is a type of dermodex related dermatitis (which as advoctaed by some, should likely be a differential diagnosis when Rosacea fials to respond to normal treatment).

Biopsy is general has little merit for Rosacea, Seb Derm (except to eliminate scarring alopecia), acne or eczema, and it may be difficult to finda derm prepared to do one if you have these diagnosis.

boo2facialredness · 28th May 2008, 05:53 PM

According to my old derm "skin doesn't lie"- whatever that is supposed to mean! According to her, the skin can be biopsied for rosacea, but EVERYTHING I've read about it says otherwise. She claimed that, unlike a blood sample, where you have to tell them what to check for, a skin sample is sent away and tells YOU what is wrong.

I have had three punch biopsies done on my face over the past year, one on each cheek and one on my forehead. Only one scar is visible (on my left cheek). Derm 2 commented that at least Derm 1 did a nice job stitching me up!

So derm 1 said "skin doesn't lie", yet it comes back with a whole bunch of differentials that are even more confusing! I had a PAS stain done (not exactly sure what that stands for) for microorganisms, and it said it was negative for "fungal hyphae". I guess that rules out seb derm?

Here's what my results say:

Microscopic Description:
Sections of skin showing: hyperkeratosis, irregular epidermal hyperplasia, spongiosis, and a perivascular inflammatory infiltrate of lymphocytes with occasional eosinophils.

Diagnosis: Spongiotic dermatitis
Differential diagnosis includes: allergic contact dermatitis, nummular dermatitis and "id" reactions.
Overall findings are most suggestive of eczamatous process.

It wasn't until months later that my allergist did patch testing and I found out I had a bunch of chemical allergies. So I guess she was right that it was (at least in part) allergic contact dermatitis. Derm 2 says it's a "rosacea flare" brought on by the use of topical steroids and my allergic reactions.

It's been a year since it started and I'm still trying to recover!

I'd definitely recommend starting with a skin scrape. Then, if the derm really thinks it's necessary, go for a more inconspicuous spot. The biopsies were easy enough, just annoying!

Good luck!

~J

Oh...and if you do get it done, ask for a copy of the results (in case you need to switch derms).

J-Mill · 28th May 2008, 08:27 PM

Quote:

Originally Posted by boo2facialredness

According to my old derm "skin doesn't lie"- whatever that is supposed to mean! According to her, the skin can be biopsied for rosacea, but EVERYTHING I've read about it says otherwise. She claimed that, unlike a blood sample, where you have to tell them what to check for, a skin sample is sent away and tells YOU what is wrong.

I don't know why...but when I read "skin doesn't lie" I LoL'd! It sounds like some cheesy used car sale pitch..."tires don't lie" or something like that. If you really want to tick a derm off, when they say something you know is full or crap, ask them for literature to back the assertion up, something form a peer related journal or a textbook, hell even a pamphlet from a semi-recognized organization.

"Skin doesn't lie", that's an epic classic, I will tell my derm that one, he will get a good laugh out of it. Sorry boo2, I am not laughing at you(r expense), I hope I am laughing with you on this one.

boo2facialredness · 28th May 2008, 08:55 PM

Quote:

Originally Posted by J-Mill

I don't know why...but when I read "skin doesn't lie" I LoL'd! It sounds like some cheesy used car sale pitch..."tires don't lie" or something like that. If you really want to tick a derm off, when they say something you know is full or crap, ask them for literature to back the assertion up, something form a peer related journal or a textbook, hell even a pamphlet from a semi-recognized organization.

"Skin doesn't lie", that's an epic classic, I will tell my derm that one, he will get a good laugh out of it. Sorry boo2, I am not laughing at you(r expense), I hope I am laughing with you on this one.

I know I gave her a weird look when she said that! And then when I saw there were so many differentials I thought, "Hmmm, skin doesn't lie b/c it doesn't know what the truth is!"

I don't think she liked that I asked for copies of the results, either. I fought for a long time before I let her do the second and third biopsies. I wish I had thought it out more and pushed for patch testing earlier. Months of wasted time and a worsening condition. You'd think SHE would have thought of it, though, since she's the "expert"! Grrr...thanfully Derm 2 suggested it a few days after I had already asked my allergist to do it (thanks to info I gathered from these boards).

If only we could write prescriptions! There is more expert advice here than from any derm I've seen!

I havne't been back to Derm 1 since I got my biopsy results. When she looked at me, admitted I had flushed twice while I was there, but still wouldn't say I had rosacea, and then said, "Well, I don't know, maybe try a new diet..." I was outta there!

~J

nbapoker · 28th May 2008, 10:00 PM

Quote:

Originally Posted by boo2facialredness

I know I gave her a weird look when she said that! And then when I saw there were so many differentials I thought, "Hmmm, skin doesn't lie b/c it doesn't know what the truth is!"

I don't think she liked that I asked for copies of the results, either. I fought for a long time before I let her do the second and third biopsies. I wish I had thought it out more and pushed for patch testing earlier. Months of wasted time and a worsening condition. You'd think SHE would have thought of it, though, since she's the "expert"! Grrr...thanfully Derm 2 suggested it a few days after I had already asked my allergist to do it (thanks to info I gathered from these boards).

If only we could write prescriptions! There is more expert advice here than from any derm I've seen!

I havne't been back to Derm 1 since I got my biopsy results. When she looked at me, admitted I had flushed twice while I was there, but still wouldn't say I had rosacea, and then said, "Well, I don't know, maybe try a new diet..." I was outta there!

~J

What exactly did you have tested by the allergist and how did you get it tested?( where on the body?, scratching, scrape?)

boo2facialredness · 29th May 2008, 01:54 AM

Quote:

Originally Posted by nbapoker

What exactly did you have tested by the allergist and how did you get it tested?( where on the body?, scratching, scrape?)

I've had all kinds of testing done, scratch testing for food and environmental stuff, serum testing for that as well. The patch testing I had done was the TRUE test. They put the panels on and left them on for 48 hours (of hell!) and then read them when they took them off, and also had me wait an hour to read them again.

Here is the link:

http://www.truetest.com/

~J

adam_h · 29th May 2008, 11:18 AM

Thanks for the replies guys, really interesting. It would seem then, a shave biopsy might be worth doing. Does that leave a mark at all?

bdeyes - A punch biopsy in the back of the neck? Would that tell you anything about the skin on your face though? Surely, it would need to be done around your face area. I only say this, because the skin at the back of my neck is fine, it is just on my t-zone area on face.

Drummergirl · 2nd June 2008, 04:53 PM

I had a punch biopsy. The derm was going to do a shave biopsy but said because I was so inflamed, she thought it would leave more of a mark than a punch biopsy...which with one stitch leaves a tiny linear mark. I had it done sort of under my chin line on a patch of inflammatory papules. The pathology report came back as "rosacea- like dermatitis". I'd been diagnosed and treated for acne by about 10 other derms, so this was what the new derm was looking for.
If it was me (and well, it was!) I just like answers, even if it leaves a tiny mark. So, the biopsy thing went well for me. And I'd just rely on the derm to tell you which biopsy is best for you and how deep into the skin they need to see to in order to say something conclusive. But yeah, you'd have to get the biopsy on the area that is causing you problems.