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Skin Biopsy

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  • Skin Biopsy

    Hi, I became unwell in Oct 2008 and, after being passed from pillar to post, I was diagnosed with Lupus in Oct 2009 based on blood results and symptoms. I was prescribed Plaquenil and told to return in 3mths. When I returned in January, my blood tests were normal and my symptoms hadn't improved. I got the impression my Rhemy was doubting I have Lupus, and he referred me for a skin biopsy.

    My Plaquenil finally kicked in mid February so I'm feeling so much better. Do you think I should still have the skin biopsy? My Rheumy said they can do it anywhere on my body because Lupus will show up in skin wherever the test is done. The Dermy I was referrred to initally didn't even examine me and was requesting the test for my face, then changed to my back. I think I'd prefer it on my arm. I've been referred to another hospital and am due to have the test this week.

    Has anyone had a skin biopsy and what should I expect, please? I must admit I'm a bit worried about having one!:sad:

  • #2
    Hello there,

    My bloods have always been ANA negative and my diagnosis was confirmed by skin biopsy. Mine was taken from my stomach as the dermy wanted "unexposed, unaffected" skin. It doesn't really hurt as you have local anaesthetic in that area, you just feel a kind of "pulling" sensation. It then just stings very slightly for a couple of days - less bothering than most nicks or cuts you might get for other reasons.

    It can be very helpful in diagnosis but is also not 100% in that it can be negative in someone who does have SLE but if it is positive then it is positive, no error there.

    Here's some more info on the skin biopsy and the figures

    By the way, it is perfectly normal not to have improved after only 3 months of plaquenil - it takes a minimum of three months to even begin working and often a lot longer before it reaches full effect. It is a very good long-term med and very much worthwhile but sometimes you might need something else if things are to bad before it kicks in.

    It is also quite common for bloods to change once on plaquenil and things like ANA are usually not even retested after diagnosis as it is not useful in monitoring the disease.

    I would be open with the rheumy and ask him what he is thinking but also keep in mind that not all rheumies are lupus (or auto-immune) specialists.


    • #3
      I hope your skin biopsy goes well!


      • #4

        As Katharine said, skin biopsies are easy as pie...just a small punch and you feel nothing. They heal up easily.

        I am serum-negative, and was DX via a skin biopsy...however, they are not always conclusive so I hope you get some satisfaction from this test.



        • #5
          I am the opposite of Katherine and Stephanie. My diagnosis was based on symptoms, postive ANA, double stranded DNA, Ro and La antibidies plus lymphopenia. My skin biopsy was in keeping with urticarial vasculitis but negative for lupus.
          It's worth having the biopsy as it is an easy test which MAY aid diagnosis, but as the others have said if negative it doesn't mean you don't have lupus.
          Good luck - let us know how it goes.


          • #6

            Good luck with the biopsy, generally they are over and done with quickly and with little discomfort.

            I must reiterate MountainbikeLynnes experience symtoms and bloods, C3, C4 were both low, ANA positive and also anti ds-dna postive which diagnosed SLE. However, my skin biopsy was negative...perhaps, not done correctly, or perhaps not in flare.

            Then again many people have been diaganosed on positive skin biopsy when bloods were inconclusive. Also as you may have read, bloods once treatment starts can stabilise and be normal, does not mean you don't have Lupus.

            I think if you have concerns you really need to phone your Rhuemi and voice them with their secretary before you go through with this procedure.

            Sorry, its all so confusing but as I said above phone the Rhuemi, afterall you say you are feeling better since Plaquenil has kicked (which is the ideal outcome), this could be reason bloods are good as your symptoms may be now in control.