BMJ  2007;334:1236 (16 June), doi:10.1136/bmj.39241.429201.3A

Letters

Skin biopsy

Watch out for digital nerves

The first 150 words of the full text of this article appear below.

As a hand surgeon, I was concerned about the bottom right picture in figure 3 of the article by Lauria and Lombardi, which seems to show that a skin biopsy had been taken from the radiovolar skin of the left index finger.1 In the summary points box it was suggested that a skin biopsy was easy and almost painless. Furthermore, nowhere was there any indication that potential injuries could be caused by the use of this technique. Skin biopsy as indicated above carries a high risk of causing a digital nerve injury leading to a neuroma causing chronic pain, which may require reconstructive surgery. If volar digital skin biopsies are required then it is much safer to harvest these in the midline of the finger, but patients should be warned of the potential nerve injury and neuroma risk as important nerves are only a few millimetres under the skin surface . . . [Full text of this article]

Bo Povlsen, consultant orthopaedic surgeon

Guy's Hospital, London SE1 7EH

bo@manusmedical.com


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Relevant Article

Skin biopsy: a new tool for diagnosing peripheral neuropathy
Giuseppe Lauria and Raffaella Lombardi
BMJ 2007 334: 1159-1162. [Extract] [Full Text] [PDF]

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