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Skin Biopsy in the Diagnosis of Hansen's Disease

Skin Smear/Biopsy Chart (PDF - 56 KB)

Indications for biopsy:

  • Possibility of Hansen’s Disease, including: Long-standing skin lesions, not responding to conventional topical treatments, skin lesions in persons with history of travel/ residence in developing country


  • Select the most active margin of the most active lesion
  • Obtain a full-thickness biopsy – it is important to see a bit of subcutaneous fat.
  • Either elliptical or punch biopsy is OK (4 mm punch is sufficient)

Fixation and processing:

  • Routine 10% neutral buffered formalin or 70% Ethanol if PCR studies are anticipated
  • Send to NHDP in fixative OR embedded in paraffin by your pathology laboratory

Send to NHDP:

  • Biopsy in formalin OR paraffin block OR 2-3 unstained slides
  • Documentation: Request form and basic patient information and clinical questions, including DOB or age. Patient treated? If yes, how long? Use of steroids?
  • What is the question you want to ask the pathologist?
  • Please include a biopsy report from your lab if examined there
  • Send by mail or courier, as you like.

Clinical Laboratory
National Hansen’s Disease Program
9181 Interline Avenue
Baton Rouge, LA 70809
Tel: 225-756-3733

If you have questions or require further information, contact:

Mara Dacso, M.D., M.S.
Dermatopathologist, NHDP
National Hansen's Disease Program
9181 Interline Avenue
Baton Rouge, LA 70809
Fax: 225-756-3734
National Hansen's Disease

Protocol and Form for Submitting Specimens for Histological Evaluation of Hansen's Disease

Protocol for Submitting Specimens for Histological Evaluation of Hansen's Disease form (PDF-13 KB)

The following are the requirements needed before sending a biopsy for routine histological evaluation:

  1. A biopsy collected with a 4 – 5 mm punch (2 mm if on face) or surgical excision, which should be deep enough to include subcutaneous fat. This depth is important because often the most prominently involved nerves will be found in the upper portion of the subcutaneous fat. As a general rule, the biopsy should be taken entirely within the lesion, preferably from the active margin if there is one.
  2. Place in 10% buffered formalin, at least 5 volumes of fixative per volume of tissue. Label container with patient’s name and biopsy site.
  3. A brief clinical history including number of lesions, changes in sensation, previous diagnosis and present clinical impressions.
  4. The patient’s name, sex, race and social security number if available.
  5. The patient’s date of birth.
  6. The submitting doctor’s name and the address where the report is to be sent.
  7. Send biopsy in leak-proof container.

The following specimens may also be submitted for evaluation (listed in order of preference):

  1. Paraffin blocks.
  2. Slides of unstained sections - preferably at least 4 slides.
  3. Stained slides to include H&E and Fite.

Specimens should be placed in protected mailing containers to prevent damage such as screw-cap cardboard cylinders or padded mailing envelopes.

Specimens are then sent to:
National Hansen’s Disease Program
Clinical Lab
9181 Interline Avenue
Baton Rouge, LA 70809
Phone 225-756-3733

Date Last Reviewed:  September 2020

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