Schamberg’s disease diagnosis by using punch biopsy

Resumo

Introdução: Skin biopsy is na auxiliary procedure to the diagnosis of many diseases. May be considered part of the list of skills of the family physician since it is relatively simple with minimal chances of complications and can be performed in a physician’s office. Schamberg's disease is a purpura with several differential diagnoses, to be sure and set treatment properly a biopsy is fundamental.

Objetivos: Conduct a brief review of the skin biopsy technique procedure and provide an experience report, where in a physician’s office a diagnostic hypothesis of Schamberg’s disease was raised and confirmed by using punch biopsy. We hereby describe the technical work of skin biopsy.

Metodologia ou descrição da experiência: Experience report on a clinical case of a girl complaining of spots on the skin for a long time. After a diagnostic hypothesis of Schamberg’s disease, a punch biopsy was made. We conducted a literature review to briefly explain the procedure: Thoroughly clean the skin to insure sterile conditions, anesthetize the área by injecting Lidocaine under the epidermis, using a sterile skin punch ranging in size from 1mm to 8mm the physician applies pressure and rotate the blade down until it has pierced the epidermis and dermis of the skin, remove the skin punch and excise the biopsy. Use sterile gauze to cover the wound and change it once a day.

Resultados: A 13 year old girl comes to a medical consultation complaining of spots on the skin, mainly in the lower limbs for roughly six months. A diagnosis of purpura was hypothesized and the laboratory tests requested showed no significant changes. The hypothesis of Schamberg’s disease was raised and punch biopsy was performed which confirmed the diagnosis.

Conclusões ou hipóteses: Skin biopsy with the use of a skin punch is a very simple method performed in 10-15 minutes in a physician’s office under local anesthesia, without the need for hospitalization and with minimal risk of complications or bleeding. It is an auxiliary procedure to the Family physician and should be performed whenever necessary.