Shave biopsies can be described and sectioned in the following manner:
- Thin, usually involving the epidermal and dermal layers of skin
- Round, oval or irregular border
- No inking required, typically
- Note all dimensions
- Cut serial sections perpendicular to long axis, about 3 mm in width
- If skin surface dimension is 3 mm or less, submit intact without sectioning
- If surface dimension is 4 mm to 8 mm, bisect though area of interest or directly beside it
- If surface dimension is 9 mm to 11 mm, trisect
- If surface dimension is greater than 12 mm, section into parallel slices about 3 mm thick
- All serial sections should be submitted in order in one or more cassettes, taking care not to place too many pieces in one cassette
- Submit entire specimen
- Process biopsy tissue on the biopsy processing program
The images demonstrate serial sectioning of a large shave.
Punch biopsies can be described and sectioned in the following manner:
- Usually involving the epidermal, dermal, and fatty layers of skin
- Cylindrical or conical core, with a semicircular/flat epidermal surface and tapered fatty end
- No inking required, typically
- Note dimensions
- If skin diameter is 3 mm or less, submit intact without sectioning
- If skin diameter is greater than 3 mm, bisect perpendicular to skin surface through area of interest or directly beside it
- If skin diameter is greater than 7mm, trisect perpendicular to the skin surface, leaving the area of interest in the center section
- Punch biopsies are limited in diameter size due to the skin sampling apparatus, where the core ranges from 1 mm to 8 mm
- Skin samples for Alopecia (for evaluation of hair follicles in hair loss) may require special transverse (rather than perpendicular) sectioning, in which the exact protocol is determined by the dermatopathologist
- Submit entire specimen
- Process biopsy tissue on the biopsy processing program
Skin curettages or scrapings can be described in the following manner:
- Thin, usually involving the epidermal and dermal layers of skin
- Irregular fragments, crescent-shaped
- No inking required
- Submit entire sample
- Multiple fragments are grouped and measured in aggregate. Any fragments too large to fit in the cassette should be sectioned.
- Process biopsy tissue on the biopsy processing program
Nail clippings can be described in the following manner:
- Thin, crescent-shaped fragments, fungal infection suspect
- No inking required
- Submit entire sample
- Measure the dimensions and submit whole or bisect if too large to fit in cassette
- Order fungal stains such as periodic acid-Schiff (PAS) and/or Grocott-Gomori methenamine silver (GMS)
- Process biopsy tissue on the biopsy processing program
- To soften nail clippings prior to microtomy, place faced paraffin block in ice water for 30 minutes
