Performing a Wound Biopsy to Diagnose Atypical Wounds

In this video, Dr. Windy E. Cole reports the results of a case series in which 3 patients who presented with rare diseases—atypical wounds—were diagnosed via biopsy results. Data were presented at the 2022 SAWC Fall; only 2 of 3 cases from the conference poster are included here.

Dr. Cole is Director of Wound Research at Kent State University College of Podiatric Medicine and National Director of Quality, Safety, and Education at Woundtech.

Transcript:

Hi, I'm Dr. Windy Cole. I'm the Director of Wound Care Research for Kent State University College of Podiatric Medicine. I'm also the National Director of Clinical Safety, Quality and Education for Woundtech. So, I have a poster here at SAWC Fall 2022 that speaks to the importance of wound biopsy to making atypical wound diagnoses.

Atypical wounds really account for about 20% of all chronic nonhealing wounds, but unfortunately, they're not studied as much in the literature because they are so rare, and we have a difficult time making diagnoses. And what I found is that biopsy is probably the best way to make the appropriate diagnoses for these atypical wounds. So, in this particular poster we looked at wounds that were not healing and we took histology, biopsy, usually 4-mm punch biopsies of the patients, and worked with our histopathologist to really determine the correct etiology and we were able to find some rare disease processes.

The 3 wounds that we diagnosed that were highlighted in this poster were cutaneous porphyria tarda. We also diagnosed pancreatic panniculitis, and then also a very rare, disseminated herpes zoster wound. So, really the discussion here, as wound care clinicians, podiatrists, whatever your background is, don't be afraid to take biopsies. They can be a very helpful tool in making these difficult diagnoses. And we know that without a proper diagnosis, we can't effectively treat patients and we can't get them to that point where we can get the wounds to heal.
 

Poster Reference: Cole WE. Wound biopsies of atypical wound presentations lead to the diagnosis of rare disease states: a case study. Poster presented at: Symposium on Advanced Wound Care (SAWC) Fall; October 14-16, 2022; Las Vegas, NV.