Which biopsy technique should be used in the workup of porokeratosis?

Updated: Oct 09, 2020
  • Author: Amarateedha Prak LeCourt, MD; Chief Editor: William D James, MD  more...
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In terms of modalities to visualize a cornoid lamellae, incisional biopsy perpendicular to the border is preferred over punch biopsy as one may lose the coronoid lamellae during processing of the punch biopsy specimen. [1]

However, a 2016 article illustrates a new biopsy technique that allows for proper orientation of the specimen during processing of PM. The authors propose a three-step technique: (1) draw a line perpendicular to the rim of the lesions, (2) then perform a punch centered at the intersection of the drawn line and coronoid lamellae, (3) then section along the perpendicular line. The laboratory acquisition should mention transection, and the cut sides should be placed down when processed. [71]

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