Biopsy-biopsy

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Just wanted to share a few thoughts with our colleagues. I had a diabetic female with a strange plantar lesion the other day. I did a superfical shave biopsy in the office which was inconclusive and recommended to the patient that we do a full wedge excision.........clear cell acanthoma! Although benign in nature and rather rare, it does stress that when there is the slightest doubt, cut it out! I have found a few malignant melanomas on the feet as well as blue nevus (pre malignant), and dermatofibromas.

 

On New Year's eve,Iwas called to see one of my regular patients at his home.He had a wound since September which his son said had gotten bigger and turned black.I started the patient on duoderm dressings and zinc oxide.I also told both men that if the wound got no better that I would biopsy just to make sure it was nothing more than a wound(I saw him today and the wound shrunk by 1/2 and the black eschar is now gone as well).The point is when in doubt biopsy it.If the wound worsens,by the way,I shall biopsy it.