I went back to the dermatologist today for a biopsy. (Thanks to my friend for unexpectedly giving me a ride!) I know they’re looking specifically for Subacute Cutaneous Lupus Erythematosus (SCLE). Dr. G said she’d be sending half the sample for a “regular workup” and the other half for an immunologic workup.

Now, I’ve never had a biopsy like this before. When I had my first colonoscopy, I know they biopsied the polyps they found, but I was knocked out for that, and it didn’t hurt afterward. This was minor surgery. I confessed to the doctor that I was nervous, and she said it wouldn’t be that bad. Of course, she had also intended to take the skin from my “right anterior thigh.” I’d made an unpleasant noise when I was told this, and said, “Oh, that’s gonna hurt.” But it turned out that my “freshest” rash was on my “right dorsal forearm.” This was okay with me, even though she said she hadn’t wanted me to have a visible scar there, because the skin is a lot less tender on my arm than it is on my thigh.

Photo of my bandaged arm post-biopsy

“You’ll just feel some pinpricks,” she assured me. Yes, those did hurt. I also felt the unpleasant sensation of the blood running down my arm as she did her thing. That’s when I understood why I had paper towels under my arm. I guess this was called a “punch biopsy,” which Wikipedia describes as such:

A punch biopsy is done with a circular blade ranging in size from 1 mm to 8 mm. The blade, which is attached to a pencil-like handle, is rotated down through the epidermis and dermis, and into the subcutaneous fat, producing a cylindrical core of tissue. The common punch size used to diagnose most inflammatory skin conditions is the 3.5 or 4 mm punch.

I clearly heard her say to her assistant this was 4mm. If you get the smaller ones, they generally don’t need stitches. This sucker, however – this one got enough stitches that it took her 2-3 minutes to sew it up. I go back on the morning of August 5 to get the stitches out.

I had my husband take a picture after he removed the gauze so I could apply a waterproof bandage. It was really gory.

I forgot to ask how long it would take to get the results back, and I’m not sure I’m patient enough to wait until I go back to get the stitches out. My mom said I should call at the end of the week if I haven’t heard anything.

Read my Big Fat Medical Update for more details.

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