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Pre‐bisection of a single skin biopsy does not produce technically inadequate specimens for direct immunofluorescence: a review of 3450 specimens
Author(s) -
Loh Ern,
Armstrong April W.,
Fung Maxwell A.
Publication year - 2014
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.12393
Subject(s) - biopsy , medicine , pathology , immunofluorescence , direct fluorescent antibody , skin biopsy , dermatology , antibody , immunology
Background Evaluation of a potential immunobullous disorder typically requires two pieces of tissue obtained by skin biopsy: one placed in formalin for conventional microscopy and a second placed in a different transport medium suitable for direct immunofluorescence ( DIF ) testing. Clinical practice in this area is not standardized, with dermatologists either obtaining two biopsies or dividing (pre‐bisecting) a single biopsy. Some DIF specimens are technically inadequate for interpretation of subepidermal imunobullous disorders because the basement membrane zone is not intact, but it is unknown whether pre‐bisecting the tissue increases the risk of compromising the specimen. Objective To investigate whether technically inadequate DIF specimens are associated with pre‐bisection. Methods DIF specimens were consecutively sampled from a single referral center and identified as whole (non‐bisected) biopsy specimens or pre‐bisected biopsy specimens. The proportion of inadequate specimens was calculated for both groups. Results A total of 3450 specimens were included. The percentage of inadequate specimens was 5.072% (153/3016) for whole (non‐bisected) specimens and 5.299% for pre‐bisected specimens. This difference was not significant (chi square, p = 0.84). The study was sufficiently powered to detect a relative risk of 1.685. Conclusions Pre‐bisection of a single skin biopsy does not significantly increase the risk of a technically inadequate specimen for direct immunofluorescence testing.