Podiatrist Tips

Biopsies in podiatry, when is it necessary?

When to do a biopsy?

Skin biopsy is useful to clarify a diagnosis for optimal management of skin conditions.

Types of skin biopsies

There are several types of biopsies: shave, elliptical, punch, aspiration, curettage, arthrocentesis and nail (matrix).

Failure of several treatments for psoriasis. Reconsider the diagnosis?

Skin punch biopsy is indicated for benign or inflammatory chronic lesions. For example, psoriasis, lichen planus or a horny papilloma. This type of biopsy allows for rapid healing. When the diameter is less than 4mm, no stitches are required.

My first AMTP is red, hot and swollen, is it the drop of a septic arthritis?

Arthrocentesis is the insertion of a needle into the joint cavity to inspect the synovial fluid. The analysis of the synovial fluid allows us to make a diagnosis by checking if it is inflammatory, septic and if there are any crystals present.

Is it a simple melanocytic nevus or a melanoma?

Brownish longitudinal band across the nail of my hallux: Striation that is evolving? The length or width of the striations is irregular? Is there destruction of the nail? Is there a darkening of the pigmentation of the striations? Is there an irregular pigmented band that appeared between the ages of 40 and 60? Is the proximal edge of the nail affected? Family history of melanoma?

When a pattern is irregular on dermoscopy, matrix biopsy of the nail is important. It may be a simple nevus, but early management of a melanoma is essential.