Skind biopsy

[Marla1225]

Hi has anyone had a skin biopsy done ? I have appointment tommorrow n my flare up is gone ... does anyone know if they can still do the biopsy since I'm not inflammed with rash ?

[lupus-support1 Administrator]

Welcome to LUpus Patients Understanding & Support (LUPUS) at HealthUnlocked.

When persons with systemic lupus have involvement of the skin of the face, several skin abnormalities can occur. These include malar erythema (butterfly rash), discoid lupus, and subacute cutaneous lupus. A biopsy of the skin will show changes of the skin that are characteristic of lupus in a majority of patients. Therefore, in helping the doctor to diagnose lupus the skin biopsy can be very important, especially when other criteria for lupus are absent.

The biopsy findings in the skin will usually demonstrate inflammation in a particular level of the skin layers (between the dermis and epidermis). Moreover, if special antibody staining tests (immunoflourescent stains for immune deposits) are also performed (take three weeks for results), then antibodies can be noted to be deposited at the junction of the dermis and epidermis. The antibodies form a line of fluorescence when viewed under a microscope and this type of examination has been referred to as a "lupus band test." It is positive when performed in involved skin in 90% of patients.

Interestingly, it is also positive in uninvolved sun-exposed skin in 80% of patients and in uninvolved non-sun-exposed skin in 50%. Therefore, in some settings doctors will do a biopsy of skin of the arm in an attempt to evaluate a facial rash of certain patients with lupus. When this test is abnormal (demonstrates antibodies deposited at the junction of the dermis and epidermis), skin disease from systemic lupus erthyematosus is felt to be present.

There is also some research that describes an increased risk for more serious forms of systemic lupus in those patients with an abnormal lupus band test.

In the proper setting, the results of a skin biopsy can directly influence the doctor's decision for optimal treatments.

The lupus band test in systemic lupus erythematosus patients

ncbi.nlm.nih.gov/pmc/articl...

Abstract

The lupus band test (LBT) is a diagnostic procedure that is used to detect deposits of immunoglobulins and complement components along the dermoepidermal junction in patients with lupus erythematosus (LE). The LBT is positive in about 70%–80% of sun-exposed non-lesional skin specimens obtained from patients with systemic LE (SLE), and in about 55% of SLE cases if sun-protected nonlesional skin is analyzed. In patients with cutaneous LE only, the lesional skin usually shows a positive LBT. The LBT helps in differentiating LE from other similar skin conditions and may also be helpful in making the diagnosis of SLE in subjects with no specific cutaneous lesions. Furthermore, a positive LBT may be applied as a prognostic parameter for LE patients. However, the correct interpretation of this test requires detailed knowledge of the site of the biopsy, deposit components, morphology and brightness of the immunofluorescent band, and other associated serologic findings, as well as the response to treatment. It must be emphasized that LBT is a laboratory procedure that should always be interpreted in conjunction with clinical findings and other serological and immunopathological parameters.

Conclusion

The LBT is a useful diagnostic tool for LE patients. However, the correct interpretation of this test requires detailed knowledge of several correlates, such as the site of the biopsy (lesional or normal skin, sun-protected versus sun-exposed skin), deposit components, morphology and brightness of the immunofluorescent band, and other associated serologic findings, as well as the response to treatment. A positive LBT on sun-protected nonlesional skin represents a sensitive and specific criterion for identifying patients with LE. Furthermore, the LBT on sun-protected normal skin may be helpful in diagnosing SLE in patients with inconclusive clinical and serological profiles and may also be of prognostic significance, particularly if all three (IgG, IgM, and IgA) immunoglobulins are found at the DEJ. Importantly, the LBT is a laboratory procedure that should always be interpreted in conjunction with clinical findings and other serological and immunopathological parameters in order to make a correct diagnosis.

We also have another website called the LuPUS Message Board where you can also post questions and talk to other people. Registration is FREE and we offer free information and free online psychological support. We specialise in psychological support with our own counsellor/psychotherapist available.

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When you register, please use the following format for entering your date of birth: nn-nn-nnnn where n=number. Please use the "-" separator and not "/".

Finally, please go to: lupus-support.org/LuPUSMB and Sign Up.

I look forward to talking with you more!

Sometimes we need to talk to people who understand and who are not family or friends.

With good wishes!

Ros

Disclaimer: No attempt is made to diagnose or to make any medical judgement. You are advised to seek the advice from your own physician. LUpus Patients Understanding & Support (LUPUS) is not a substitute for your own doctor.