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A punch biopsy is essentially an incisional biopsy, except it is round rather than elliptical as in most incisional biopsies done with a scalpel. Incisional biopsies can include the whole lesion (excisional), part of a lesion, or part of the affected skin plus part of the normal skin (to show the interface between normal and abnormal skin).
The exact cause of this condition is not known, but it involves collagen degeneration and a granulomatous response in the layer of the skin called the dermis, often affecting the deeper fat layer and thickening dermal blood vessels. Diagnosis is confirmed through a skin biopsy showing inflammatory cell infiltrate and necrotising vasculitis.
Recurrent ulceration and fat necrosis is associated with lipodermatosclerosis. In advanced lipodermatosclerosis the proximal leg swells from chronic venous obstruction and the lower leg shrinks from chronic ulceration and fat necrosis resulting in the inverted coke bottle appearance of the lower leg.
Some surgeons advocate the removal of the complete scar in the treatment of "recurrent" skin cancers. Others advocate removing only the island of local recurrence, and leaving the previous surgical scar behind. The decision is often made depending on the location of the tumor, and the goal of the patient and physician.
If there is a persistent sore that does not heal or a growing lump within the rash, a skin biopsy should be performed to rule out the possibility of skin cancer. If the erythema ab igne lesions demonstrate pre-cancerous changes, the use of 5-fluorouracil cream has been recommended.
Fat necrosis is necrosis affecting fat tissue (adipose tissue). [1] The term is well-established in medical terminology despite not denoting a specific pattern of necrosis. [ 2 ] Fat necrosis may result from various injuries to adipose tissue, including: physical trauma, enzymatic digestion of adipocytes by lipases , [ 3 ] radiation therapy ...
Occasionally medical imaging or tissue biopsy is used to confirm the diagnosis. [1] Treatment is typically by observation or surgical removal. [1] Rarely, the condition may recur following removal, but this can generally be managed with repeat surgery. [1] They are not generally associated with a future risk of cancer. [1]
The great disadvantage, seen years later is the numerous scallop scars, and a very difficult to deal with lesions called a "recurrent melanocytic nevus". What has happened is that many "shave" excisions does not adequately penetrate the dermis or subcutaneous fat enough to include the entire melanocytic lesion.