Sarcoidosis is an inflammatory disease marked by the formation of small clusters of inflammatory cells, called granulomas. In long-term or chronic cases, these granulomas can build in organs and tissues, causing damage and a wide range of symptoms of varying intensity. Diagnosis can be difficult, as sarcoidosis can mimic many other conditions.

In about 30 percent of all patients, sarcoidosis has some form of skin involvement, typically seen as red nodules, bumps, and plaques. These can range in severity from mild to disfiguring, and are often the first symptom a patient notices and brings to the attention of their doctor.

A skin biopsy may be taken to determine their cause.

What is a skin biopsy?

A skin biopsy is a sample of skin taken directly from the affected area and then analyzed in the laboratory.

The sample is taken after the patient is given a local anesthetic, injected at biopsy site, to relieve pain. The procedure causes a small wound and recovery and healing time is usually short.

Skin biopsy for sarcoidosis

If the doctor suspects that the patient has an inflammatory condition such as sarcoidosis, a punch biopsy is often done. This procedure removes a circle of skin tissue, down to the first layer of fat beneath the skin. It is small and precise, requiring little post-biopsy care. The sample is analyzed in a laboratory for the presence of granulomas and inflammatory molecules.

According to a comparative study published in 2013 in the journal Multidisciplinary Respiratory Medicine, punch biopsies can diagnose sarcoidosis in 81.6 percent of cases.

Other types of skin biopsy

Other types of skin biopsy may be used to diagnose sarcoidosis, including:

  • Shave biopsies that remove only the top layer of the affected skin. Although bleeding may occur, the wound does not need much care.
  • Incision or excision biopsies that cut out the affected area, causing a larger wound. Stitches and the like may be needed to close the wound,  and the patient may needs to undergo checks to ensure to make sure that the wound is healing properly and to remove stitches or other wound closings.

Skin samples taken in biopsies may also be examined for infections such as tuberculosis to rule out other potential causes of rashes and other skin symptoms.

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