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BMJ. 2007 June 16; 334(7606): 1236.
PMCID: PMC1892476
Skin Biopsy

Watch out for digital nerves

Bo Povlsen, consultant orthopaedic surgeon

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 on fingers.

Notes

Competing interests: None declared.

References

1. Lauria G, Lombardi R. Skin biopsy: a new tool for diagnosing peripheral neuropathy. BMJ 2007;334:1159-62. (2 June.) [PMC free article] [PubMed]

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