PMID: 9555792Apr 29, 1998Paper

"Rush" skin biopsy specimens in a tertiary medical center: diagnostic yield and clinical utility

Journal of the American Academy of Dermatology
S K BarksdaleR L Barnhill

Abstract

Skin biopsy specimens are submitted for "rush" or "stat" processing, thereby indicating a sense of urgency about the clinical situation. Our purpose was to determine the patient population who underwent biopsy on a "rush" basis and assess the way in which interpretation of the skin biopsy specimen influences clinical management. A retrospective study was performed on the "rush" biopsy specimens sequentially requested during 1 year. Histologic findings, the clinical situation, and the effect of the biopsy result on clinical management were determined. A total of 90 adult patients, many critically ill, were identified. The majority of patients were admitted to hematology-oncology services (58%). The other 42% were admitted to a variety of clinical services. The chief clinical concerns in hematology-oncology patients were graft-versus-host disease and cutaneous infection. Only 5.5% of biopsy specimens taken to exclude graft-versus-host disease were used in immediate clinical decision-making compared with 45% of biopsy specimens for oncology patients with suspected infection and 42% for all other services. Many urgent skin biopsy specimens were not used for immediate clinical decision-making. The usefulness of skin biopsy varies wi...Continue Reading

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