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Dermbits

Do you ever need to perform a skin biopsy on patients with atopic dermatitis?

Atopic Dermatitis

You? I think that's a really important question, because while it's true that this is generally a clinical diagnosis and usually you do not need to do any special testing, occasionally you do. Number one thing we're looking for is not that it is atopic dermatitis, but that it isn't atopic dermatitis. So particularly in patients who are very severe or in those where we feel like nothing is working correct, it's being very refractory disease. Or if we feel that it's a very uncharacteristic or uncommon pattern, then I'm going to say, okay, are we sure that this is atopic dermatitis? And that's really where a skin biopsy helps us. It will help us exclude things like, or make the diagnosis of cutaneous t cell lymphoma, a nutritional deficiency, scabies infestation sometimes. So things like that. But generally speaking, we don't have to do it. We usually don't. And it turns out that it's generally not very helpful in the context of true atopic dermatitis because there's not a way that you can really cinch the diagnosis using the biopsy. In general, it's just sort of consistent with. And usually you get more of a descriptive report, something like spongiotic dermatitis with perivascular lymphoistiocytic infiltrate could be consistent with atopic dermatitis or drug eruption in the proper clinical context. So in general, we're not doing it, but absolutely in the right context, it can make or break it for a patient.