Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A biopsy is a sample of tissue removed by your doctor to
make a precise diagnosis. Biopsy procedures can range from a simple sampling of
skin under local anesthesia to surgical opening of the chest wall to remove a
portion of lung tissue. Biopsies may also be obtained during diagnostic
procedures such as endoscopy, colonoscopy, bronchoscopy, and others. Sometimes
doctors perform biopsies using a CAT scan or other radiological imaging
techniques to help identify the exact area to be sampled and avoid injury to surrounding organs.
There are several types of biopsies.
Excisional biopsy. If your doctor finds an area of interest or a suspicious finding
(for example, an enlarged nevus, or mole), often an excisional biopsy is
performed to remove the area in question in its entirety during the
biopsy.
Incisional biopsy. An incisional biopsy refers to removal of only a portion of the area of
interest (for example, sampling of a small fragment of tissue from a larger
breast lump).
Fine needle biopsy. A fine needle biopsy is used to remove cells or fluid by
suctioning through a long, thin needle.
Core needle biopsy. During a
core needle biopsy, the doctor inserts a special needle through a skin incision
that removes a very thin,
cylindrical piece of tissue.
The following questions can help guide your discussions with your doctor
concerning a biopsy (print these and take them with you to your doctor's visit).
A skin biopsy is the removal of a piece of skin for the purpose of further
examination in the laboratory using a microscope. Skin biopsies are performed to
diagnose a number of conditions.
Why is a skin biopsy performed?
Skin biopsy is most frequently done to diagnose a skin growth such as a mole,
or a skin condition such as a rash. A skin biopsy can also be used to diagnose a
cancer of the skin. A skin biopsy may be indicated when a mole or other marking
on the skin has changed in its shape, color, or size. A skin biopsy is also
sometimes used to diagnose infections of the skin.
What methods are used to obtain a skin biopsy?
Different techniques are used in different situations. Typically the biopsies
are obtained using local anesthetics.
A shave biopsy takes a thin slice off the
top of the skin and can be used to remove superficial abnormal areas (lesions).
A punch biopsy takes a core (a small cylindrical fragment of tissue from the
area of interest) and can be used to remove small lesions as well as diagnose
rashes and other conditions.
Excisional biopsies are usually larger and deeper
and are used to completely remove an abnormal area of skin such as a skin
cancer.
What happens to the skin sample after the biopsy is removed?
After the biopsy, the skin sample is fixed in special solution, and thin
sections of the tissue are cut and placed on microscope slides. The slides are
stained for examination by a doctor (usually a dermatologist or pathologist).
Sometimes specialized stains are used to examine for antibodies, immune
proteins, and other markers of certain diseases. Initial routine biopsy results
can be obtained in 48 hours or less, while specialized staining techniques can
require a much longer time until final results are available.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Eczema, also known as dermatitis, is a general term for many types of skin inflammation. The most common form of eczema is atopic dermatitis. The other forms of eczema include: contact eczema, seborrheic eczema, Nummular eczema, Neurodermatitis, stasis dermatitis, and dyshidrotic eczema. Symptoms, diagnosis, and treatment of eczema may vary from person to person and may depend on the type of eczema.
A skin tag is a small benign growth of skin that projects from the surrounding skin. Skin tags can vary in appearance (smooth, irregular, flesh colored, dark pigment, raised). Skin tags generally do not cause symptoms unless repeatedly irritated. Treatment for skin tag varies depending on the location on the body.
MRSA (methicillin resistant Staphylococcus aureus) bacteria causes skin infections with the following signs and symptoms: cellulitis, abscesses, carbuncles, impetigo, styes, and boils. Normal skin tissue doesn't usually allow MRSA infection to develop. Individuals with depressed immune systems and people with cuts, abrasions, or chronic skin disease are more susceptible to MRSA infection.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Ingrown hairs may be caused by improper shaving, waxing or blockage of the hair follicle. Symptoms and signs of ingrown hairs include itching, tenderness, and small red pus bumps. Ingrown hairs usually heal on their own, but topical antibiotics, chemical depilatories, and hair-removal laser may be used in the treatment of ingrown hairs.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Henoch-Schonlein Purpura (HSP or anaphylactoid purpura), a type of blood vessel inflammation, results in rash, arthritis, and occasional abdominal cramping. HSP often resolves on its own. Joint pain may be treated with anti-inflammatory and cortisone medications.
Actinic keratoses are rough, scaly patches of skin that are considered precancerous and are due to sun exposure. Prevention is to cut sun exposure and wear sunscreen.
Rabies is a potentially fatal viral infection. Rabies symptoms include fever, headache, myalgia, and can progress to more serious symptoms such as seizures, coma and death. The rabies vaccine (rabies treatment) should be administered immediately after the person or pet has been bitten.
Pityriasis rosea is a rash that begins with a large pink patch with well-defined scaly borders on the back, chest, or neck. In one to two weeks, the person will develop many smaller pink patches on his or her trunk, arms, and legs. Symptoms include mild itching and possible sore throat, fatigue, nausea, aching, and decreased appetite. Pityriasis rosea typically resolves on its own and symptoms may be treated with topical steroid creams and oral antihistamines.
Dry skin (xeroderma) may be caused by external factors, like cold temperatures, low humidity, harsh soaps, and certain medications, or internal factors, such as thyroid disease, diabetes, psoriasis, or Sjogren's syndrome. Symptoms and signs of dry skin include itching and red, cracked or flaky skin. The main treatment for dry skin is frequent, daily lubrication of the skin.
Molluscum contagiosum is a skin infection caused by the poxvirus. Molluscum contagiosum appears as small tan or pink bumps on any part of the skin. Symptoms include a red or flushed appearance of the infected skin. Treatment may involve cryotherapy, manual extraction, surgical removal, the use of Retin-A, or the application of chemical acid.
Lichen sclerosus is a skin disease that causes white spots to form on the skin, which later grow into large, thin, and crinkled patches of skin that tear easily. Symptoms include itching, pain, blisters, and bleeding. Patches on the upper body usually go away over time, but patches in the genital region may scar if left untreated, causing problems with urination or sex. Treatment may involve surgery or the use of a very strong cortisone cream.
Moles are small skin growths that may appear flat or raised and are often tan, brown, black, reddish brown, or skin colored. They are typically about the size of a pencil eraser. There are three types of moles. Monthly skin self-exams are essential in the early detection of abnormal moles and melanomas.
Eosinophilic fasciitis is a skin disease that causes thickening and inflammation of the skin and fascia. Symptoms include redness, warmth, and hardening of the skin, as well as occasional tissue and joint pain. Treatment for eosinophilic fasciitis aims to eliminate inflammation through the use of aspirin, NSAIDs, and cortisone. Aggressive forms of eosinophilic fasciitis may require the use of immune suppression medications.
Typhus is a disease caused by Rickettsia bacteria. Symptoms and signs include fever, headache, nausea, vomiting, diarrhea, and rash. Antibiotics are recommended as the treatment for endemic and epidemic typhus infections.
Weber-Christian disease is a rare inflammatory disease that affects the body's fat tissues. It's also known as relapsing febrile nodular panniculitis syndrome and idiopathic lobular panniculitis. The disorder appears on the skin as red or purple tender, raised lumps. The thighs and lower legs are the most frequently affected areas. Other symptoms may include nausea, vomiting, weight loss, joint pain, and abdominal pain. Though there is no cure for the disease, inflammation may be treated with various antiinflammatory medications.
Melioidosis (Whitmore's disease) is an infectious disease caused by Burkholderia pseudomallei bacteria. Symptoms include bronchitis, pneumonia, fever, headache, loss of appetite, cough and chest pain. Treatment involves antibiotics or surgical removal of the lung abscess in severe cases.
Skin tags are common, acquired, benign skin growths that look like a small piece of soft, hanging skin. Skin tags are harmless growths. Some individuals may be more prone to tags (greater than 50-100 tags) either through increased weight, in part combined with heredity, or other unknown causes. Males and females are equally prone to developing skin tags. Obesity and being moderately overweight (even temporary increases in weight) dramatically increase the chances of having skin tags.
Women of normal weight with larger breasts are also more prone to developing skin tags under their
breasts. Some small tags spontaneously rub or fall off painlessly and the person may not even know they had a skin tag. Most tags do not fall off on their own and persist once formed. The medical name for skin tag is acrochordon.
Skin tags are bits of skin- or flesh-colored tissue that project from the surrounding skin from a small, narrow stalk. Some people ca...
A biopsy is a sample of tissue removed by your doctor to
make a precise diagnosis. Biopsy procedures can range from a simple sampling of
skin under local anesthesia to surgical opening of the chest wall to remove a
portion of lung tissue. Biopsies may also be obtained during diagnostic
procedures such as 
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