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Biopsy Techniques for Actinic Keratoses Differ by Specialty

Plastic surgeons choose a more invasive biopsy, dermatologists opt for less disfiguring one

TUESDAY, April 25 (HealthDay News) -- Plastic surgeons tend to choose excisional biopsies while dermatologists are more likely to use shave biopsies for the histopathological examination of actinic keratoses, according to a study in the April issue of Archives of Dermatology.

Klaus Sellheyer, M.D., and Wilma F. Bergfeld, M.D., from The Cleveland Clinic Foundation in Ohio, retrospectively compared the biopsy techniques used by plastic surgeons and dermatologists for the histopathological examination of 405 actinic keratosis biopsy specimens.

The researchers found that excisional biopsies were performed in 50 percent of cases by plastic surgeons but only 1.4 percent of cases by dermatologists. In contrast, shave biopsies were performed in 89.4 percent of cases by dermatologists compared with only 32.4 percent of cases by plastic surgeons.

"The predominance of excisional biopsies of actinic keratoses by plastic surgeons may be related to a different ability in the clinical recognition of actinic keratoses compared with that of dermatologists," Sellheyer and Bergfeld conclude. "The surgical approach of dermatologists to shave diagnostically uncertain cutaneous lesions is less invasive than that of plastic surgeons and is more likely to achieve a better cosmetic outcome."

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