Safety profile of chronic leg ulcer biopsy: a monocentric retrospective series

Skin biopsy is an important tool for various skin conditions. However, in the case of leg ulcers, some Authors still consider it highly risky and mandatory only in selected cases.

The aim of this study was to evaluate the rate of adverse events after leg ulcers biopsy in 866 consecutive patients referring to our Wound Care Unit in Bologna from January 2008 to December 2016. Two biopsies were performed (from the border and the centre) by the same dermatologist following a standardized structured protocol.

A total of 329 males and 537 females (ratio of 1:1.6), mean age 72 years (range 50-97 years) underwent a skin biopsy. Up to 70% of all analyses revealed a vascular ulcer (614 patients; 70.9%) while other conditions (252 patients; 29.1%) included inflammatory dermatitis, vasculitis, ulcerated neoplasms, infective lesions, post-traumatic and pressure sores, erosive pustular, dermatitis and pyoderma gangrenosum. Adverse events occurred in 322 patients (38.43% of all biopsies), mostly a dull pain (320 patients, 37%) that resolved within some hours. Five patients with vasculitis (0.6%) experienced a worsening of the lesion and another five patients (0.6%) developed erysipelas. Only two patients, on double antithrombotic therapy (0.23%), had intraoperative bleeding. No allergic reactions were detected.

According to our experience, skin biopsy should be mandatory for non-healing wounds. It is safe and involves only a low rate of adverse events.