Necessary Information

1. Date of collection and location of biopsy site are required: whether biopsy was obtained from sun-exposed verses unexposed skin, and whether it is from perilesional, involved, or uninvolved skin.

2. Pathology Report/Clinical Notes are required (include a brief history, pertinent laboratory results, suspected diagnosis, and reason for testing).

Specimen Required

Two or more biopsies from same site and sent in 1 specimen vial will be processed as 1 specimen. Two or more biopsies from different sites require separate specimen vials, however, they can be ordered together. Test performed on each site will be billed accordingly.

Transport Medium Method

Supplies: Michel's Transport Media for Immunofluorescent Testing on Tissue (T321)

Specimen Type: Tissue

Sources: Skin or 1 of the following mucosae: oral (oropharyngeal), nasal, genital, esophageal, conjunctival, laryngeal, or epiglottis

Container/Tube: Transport medium (Michel's, also called Zeus media)

Specimen Volume: 2-8 mm punch specimen, intact or bisected; excisional biopsy specimen intact or bisected

Collection Instructions:

1. Collect biopsy of uninvolved or involved skin. Refer to Recommended Biopsy Site Selection Based on Disease State below.

2. Immediately place specimen into a labeled vial of transport medium and seal tightly.

Snap-Frozen Method

Specimen Type: Tissue

Sources: Skin or 1 of the following mucosae: oral (oropharyngeal), nasal, genital, esophageal, conjunctival, laryngeal, or epiglottis

Container/Tube: Plastic vial

Specimen Volume: 2-8 mm punch specimen, intact or bisected; excisional biopsy specimen, intact or bisected

Collection Instructions:

1. Collect biopsy of uninvolved or involved skin. Refer to Recommended Biopsy Site Selection Based on Disease State below.

2. Immediately place specimen into liquid nitrogen and allow to freeze thoroughly (do not allow specimen to desiccate). If liquid nitrogen is not available, specimen may be frozen by placing it on a small square of aluminum foil on a block of dry ice. Liquid nitrogen is preferred.

3. Immediately wrap specimen carefully in aluminum foil. At no time should the specimen be allowed to thaw.

4. Place the wrapped specimen into the prelabeled plastic vial and seal tightly. Ship frozen.

1. Pemphigus and pemphigoid groups (including linear IgA bullous dermatosis and chronic bullous disease of childhood): Biopsy erythematous perilesional skin or mucosa. Avoid erosions, ulcers, and bullae while obtaining tissue adjacent to active lesions. Label as perilesional skin.

2. Dermatitis herpetiformis: Biopsy normal-appearing skin, 0.5-1 cm away from lesion. Label as perilesional skin.

3. Lupus erythematosus: Involved areas of skin such as erythematous or active borders are preferred biopsy sites to confirm the diagnosis of lupus erythematosus, either discoid or systemic. Label as involved skin. Avoid ulcers, old lesions, and facial lesions, if possible. Uninvolved, nonexposed skin is the preferred site to detect a lupus band as may be found in systemic lupus erythematosus. Should unexposed skin be desired, buttock or medial thigh is suggested. Label as uninvolved, nonexposed skin.

4. Mixed connective tissue disease: Biopsy as for lupus erythematosus except when sclerodermoid features are present. For sclerodermoid features, biopsy inflamed area. Label as involved or uninvolved, exposed or nonexposed skin.

5. Vasculitis and urticaria: The erythematous or active border of a new lesion is preferred. Avoid old lesions and ulcers. Label as involved skin. If appropriate, skin lesion is not present, diagnosis may sometimes be made from uninvolved skin.

6. Porphyria cutanea tarda: Biopsy involved skin. Avoid old lesions and ulcers. Label as involved skin.

7. Lichen planus and lichenoid reactions: Biopsy involved skin. Avoid old lesions and ulcers. Label as involved skin.