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Corn biopsy - Large Biopsy 3-6 cm

Biopsy
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Report in 288Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Skin biopsy.

₹666₹951

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Corn Biopsy - Large Biopsy 3-6 cm

  • Why is it done?
    • Test Measures: A corn biopsy is a tissue sample obtained from a corn (heloma) - a thickened area of skin that develops on the feet, typically over bony prominences. A 3-6 cm large biopsy allows for comprehensive histological examination of the lesion.
    • Primary Indications: To rule out malignancy or atypical conditions in a suspicious corn lesion; to differentiate corns from other skin conditions (warts, calluses, keratosis); to evaluate corns that have not responded to conservative treatment; to assess for unusual histological findings or malignant transformation.
    • Timing and Circumstances: Performed when clinical examination suggests atypical features; when a lesion persists despite appropriate conservative management; when malignancy cannot be clinically excluded; as part of comprehensive evaluation of unusual foot lesions; when differential diagnosis includes more serious pathology.
  • Normal Range
    • Normal Histological Findings: Benign corn tissue shows characteristic features including plantar keratosis (thickened stratum corneum); organized hyperkeratosis with a cone-shaped core extending into the dermis; intact basement membrane; no evidence of atypical cells or malignancy; normal dermal and epidermal architecture.
    • Reference Values: Absence of malignant cells; no dysplasia present; normal inflammatory response; preserved tissue architecture; negative for human papillomavirus (HPV) in most cases.
    • Interpretation of Results: Negative/Normal = benign corn with typical histology, no malignancy, no further investigation needed; Borderline = findings show atypical features requiring clinical correlation and possible additional studies; Positive/Abnormal = malignant or significantly atypical findings requiring immediate further management and treatment.
    • Units: Histopathological examination reported as descriptive microscopic findings with qualitative assessment of cellular characteristics, tissue organization, and presence/absence of atypical features.
  • Interpretation
    • Benign Corn (Normal Finding): Diagnosis of heloma (corn) confirmed with typical histology showing concentric layers of compact keratin forming a cone shape; normal epidermal-dermal interface; inflammatory infiltrate may be present but is non-specific; reassures that lesion is not malignant and confirms clinical diagnosis.
    • Plantar Wart (Verruca Plantaris): Histology shows koilocytic cells (HPV-infected keratinocytes); viral inclusions; irregular hyperkeratosis; acanthosis with elongation of rete ridges; often HPV-positive by PCR; requires different treatment approach than simple corns.
    • Acanthosis Nigricans or Pigmented Lesion: Dark staining keratin or melanin deposition; abnormal pigmentation; may indicate metabolic syndrome association or need for dermoscopic evaluation; benign but may require systemic workup.
    • Squamous Cell Carcinoma (SCC): Malignant finding with invasion into dermis and subcutis; cellular atypia; increased mitotic activity; abnormal keratinization; requires immediate treatment and staging; increased risk in immunocompromised patients and chronic wound sites.
    • Melanoma or Atypical Melanocytic Lesion: Presence of atypical melanocytes; increased mitotic figures; architectural disorder; junctional activity; requires STAT evaluation and oncology consultation; poor prognosis if confirmed.
    • Factors Affecting Interpretation: Specimen fixation quality; tissue depth and orientation; immunohistochemical staining quality; pathologist expertise in foot lesion histology; adequate sampling of lesion margins; clinical history provided to pathologist.
    • Clinical Significance: Definitive diagnosis eliminates diagnostic uncertainty; guides treatment decisions; determines prognosis; establishes baseline for follow-up; provides reassurance when benign; identifies need for oncologic referral when malignancy present.
  • Associated Organs
    • Primary Organ System: Integumentary system (skin); specifically the epidermis and dermis of the plantar surface of the foot; associated with underlying bone prominence (metatarsal heads, interphalangeal joints) where mechanical pressure causes lesion development.
    • Associated Medical Conditions - Benign: Mechanical calluses from ill-fitting shoes; diabetic foot complications; rheumatoid arthritis with joint deformity; hallux limitus; pes planus (flat feet); Morton's neuroma adjacent to corn.
    • Diseases Identified by This Test: Squamous cell carcinoma of the foot (cutaneous SCC); basal cell carcinoma; malignant melanoma; merkel cell carcinoma; plantar warts (verruca plantaris); mycotic infections; dermatophyte infections; keratoacanthoma.
    • Potential Complications and Risks: Infection at biopsy site; delayed wound healing (especially in diabetic or immunocompromised patients); scarring; persistent pain; loss of sensation if nerve is traumatized; tumor seeding (rare with proper biopsy technique); need for more extensive surgical intervention if malignancy confirmed.
    • Associated Systemic Conditions: Acanthosis nigricans (metabolic syndrome); immunosuppression (increased malignancy risk); human papillomavirus infection; xeroderma pigmentosum; chronic kidney disease; diabetes mellitus (impaired healing).
  • Follow-up Tests
    • If Benign Corn Confirmed: Clinical follow-up as needed for symptomatic management; patient education on proper footwear and corn prevention; periodic examination if recurrent; no additional testing required unless new symptoms develop.
    • If Plantar Wart Identified: HPV typing (can determine high-risk vs low-risk strains); viral load testing; repeat biopsy if clinically indicated; assessment for immunosuppression status; consideration of antiviral or immunotherapy options.
    • If Squamous Cell Carcinoma Detected: Complete surgical excision with appropriate margins; sentinel lymph node biopsy if high-grade or large lesion; CT or MRI for staging; oncology referral; dermatology consultation; lymph node ultrasound or imaging if clinical suspicion of metastasis.
    • If Melanoma Suspected: STAT pathology review; immunohistochemistry (S100, Melan-A, HMB-45); Breslow thickness measurement; Clark level assessment; complete surgical excision with wide margins; sentinel lymph node biopsy; PET-CT or brain MRI for staging; oncology referral; molecular testing (BRAF, NRAS, KIT).
    • Monitoring Frequency: For benign corns: annual clinical examination; for treated malignancy: clinical surveillance every 3 months for year 1, every 6 months for year 2-3, then annually; skin self-examination monthly; imaging as indicated based on staging.
    • Complementary Tests: Dermoscopy of similar lesions; photographic documentation for monitoring; mycology culture if fungal infection suspected; immunological testing if immunosuppression suspected; metabolic panel if acanthosis nigricans present (screening for diabetes and metabolic syndrome).
  • Fasting Required?
    • Fasting Status: No - Fasting is not required for a corn biopsy. This is a local tissue sampling procedure requiring only topical or local anesthesia, not systemic medication or general anesthesia.
    • Pre-Procedure Instructions: Patient may eat and drink normally before appointment; no specific fasting period required; take all regular medications as scheduled unless specifically instructed otherwise by the physician.
    • Medications to Avoid: Discontinue anticoagulants (warfarin, apixaban, rivaroxaban, dabigatran) 3-5 days before procedure if possible; hold aspirin and NSAIDs for 5-7 days prior (consult with prescribing physician); stop herbal supplements with anticoagulant properties (ginger, ginkgo, garlic) 7 days before; continue all other medications normally.
    • Patient Preparation Requirements: Wash feet thoroughly with soap and water the morning of procedure; wear clean, loose-fitting shoes or sandals; avoid lotions, oils, or creams on feet for 24 hours before biopsy; inform physician of any allergies to local anesthetics (lidocaine, novocaine); inform of any bleeding disorders or anticoagulation therapy; have someone available for transportation if sedation used; avoid strenuous activity for 24-48 hours post-procedure.
    • Special Considerations for Diabetic Patients: Inform provider of diabetes status; monitor biopsy site closely for infection; keep feet elevated when possible post-procedure; avoid walking immediately after biopsy to prevent wound complications; increased infection risk may warrant prophylactic antibiotics; delayed healing is common and expected.
    • Post-Procedure Care: Keep biopsy site clean and dry; follow wound care instructions provided by healthcare provider; use topical antibiotic ointment if recommended; monitor for signs of infection (increased redness, warmth, drainage, odor); wear protective dressing for 24-48 hours; avoid soaking feet or strenuous activity; pain is typically minimal; contact provider if excessive bleeding or signs of infection develop.

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