Significance of Single Vs Multiple Skin Biopsies

Abstract

Skin biopsy is an important investigation but the results are not always conclusive. Our aim was to evaluate the diagnostic value of single and multiple skin biopsies in dermatological diseases. The study was prospective and comparative. We examined 798 skin biopsies in 572 patients. Biopsy was taken form one or more sites and fixed, processed, sectional and stained. Diseases with diagnostic histopathology were evaluated and the percentage of patients in whom a biopsy was taken from a single or multiple sites was calculated. Biopsies were taken from 310 males and 262 females, aged between three to eight years. Histopathology was diagnostic in 66.6%, 78.6% and 90.9% patients when one, two or three biopsies, respectively, were taken. The difference between one and two biopsies was highly significant, especially in autoimmune bullous diseases and lichen planus. In eczemas, cutaneous tuberculosis, sarcoidosis and lupus erythematosus and lupus erythematous there was no significant difference when biopsy was taken from one or two sites. Skin biopsies form two sites yield better histopathological results than a single biopsy, especially in autoimmune bullous disease and lichen planus. Single biopsy is sufficient in eczemas, tuberculosis, sarcoidosis and lupus erythematosus. Larger sample size is required to know the significance of three biopsy sites.