Hautbiopsie bei entzündlichen Hauterkrankungen im Kindesalter – wann ist sie sinnvoll?

Abstract

Compared with adulthood, inflammatory skin diseases are relatively rarely biopsied in children. Apart from the invasiveness of the procedure, the required local anesthesia, and the risks of infection and scarring, the psychological trauma of the operation has a higher impact in childhood. If a biopsy is performed, expectations towards the dermatopathology report are high. However, the evaluation of biopsies taken from children is challenging for the dermatopathologist: on the one hand, because the biopsies are often tiny or just superficial shaves and, on the other hand, because criteria for evaluation have mostly been developed from findings in adult biopsy specimens. In children, the immune system is still in the process of maturation and, therefore, infiltrates in the skin may look different from those seen in adults; however, knowledge about that is very limited to date. Moreover, numerous rare genodermatoses may manifest themselves first in childhood and need to be considered in the differential diagnosis while experience with them is often limited. Starting from the clinical presentation, this article presents histopathological features of possible differential diagnoses in order to demonstrate the value or necessity of a skin biopsy in a pediatric patient. In addition, communication with parents and child, methods of local anesthesia and biopsy techniques will be considered.

Isolated linear psoriasis: case report on an eight‐year‐old child

“…Skin biopsy in children requires a critical review. Further information regarding a reasonable use of skin biopsy in childhood is discussed by Böer-Auer et al [14].…”

Isolierte lineare Psoriasis: Fallbericht bei einem achtjährigen Kind

“…Hautbiopsien sollten nur nach einer kritischen Überprüfung durchgeführt werden, insbesondere bei Säuglingen, bei denen unter Umständen eine Kurznarkose erforderlich ist. Weitere Informationen zu einem Einsatz von Hautbiopsien im Kindesalter werden von Böer-Auer et al beschrieben [14].…”