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the microsampling blog

the role of skin biopsy in infectious skin diseases research

A microscopic view of skin pathogens


Skin biopsies have been a cornerstone of dermatology for over a century. The early 20th century saw the development of fundamental techniques like shave biopsies, punch biopsies, and excisional biopsies. These methods paved the way for more accurate diagnoses of skin diseases, revolutionizing how dermatologists approach skin infections and inflammatory conditions. Skin biopsies are indispensable for diagnosing a wide array of skin conditions, such as: 

  • Infections: Biopsies can detect bacterial, fungal, parasitic, or viral infections in the skin, leading to targeted treatment approaches. These insights help ensure that patients receive the most appropriate care for their condition.

  • Evaluating Rashes and Lesions: Biopsies offer vital diagnostic clarity in cases of unexplained rashes or lesions. By identifying the root cause, healthcare providers can implement effective treatments, alleviating symptoms and preventing further complications. 

Skin biopsies are critical for dermatological diagnostics—providing detailed information that enables healthcare professionals to make informed clinical decisions.   

comparative analysis: traditional biopsy vs. Microbiopsy techniques 

Traditional biopsy methods have been an effective, standard approach for decades, but with some notable drawbacks. Traditional methods frequently require anesthesia and expensive sampling procedures that involve cutting into the skin to remove a specimen. These biopsy methods often entail the following disadvantages: 

  • Invasiveness: Requires cutting large pieces of skin tissue, resulting in permanent scarification of the patient.

  • Pain Level: Significant discomfort and during and after the procedure.

  • Wound Care: Leaving patients with extended wound care and recovery times.

  • Cost: Requires experienced physicians and nurses to perform specialized procedures.

  • Frequency: Not suitable for collecting multiple biopsies from a patient at a single time point or in a narrow time window. 

In contrast, the Harpera™ Microbiopsy™ Punch is a high-precision laser-cut punch device that extracts minimal skin tissue, drastically reducing patient discomfort and eliminating the need for stitches—offering a non-invasive alternative for collecting skin specimens using a spring-loaded punch mechanism to quickly collect micro-sized specimens. 

slose up a skin infection on the face of a man

The Microbiopsy procedure offers significant benefits when collecting skin biopsies in populations that are impacted by infectious diseases, particularly those diseases affecting the skin. The minimally invasive nature of the Harpera Microbiopsy Punch can be ideal for reducing complications when collecting samples from infected or wounded skin. This less invasive method can minimize the risk of further trauma. Microbiopsy enables the scientific community to collect skin specimens more easily than they could using traditional sampling methods.1

For instance, collecting samples over time is invaluable in tracking the progression of vector-borne diseases. The Harpera enables repeated, frequent and non-invasive sampling, which would facilitate this process. This advantage would be particularly beneficial for monitoring asymptomatic populations that may unknowingly spread infections.2

Furthermore, the device's ease of use enables widespread specimen collection across large populations. This device is so easy to use that any healthcare provider, not only specially trained surgeons, can utilize it, making it ideal for field studies in remote or resource-limited settings. This broad applicability supports large-scale epidemiological studies and enhances disease surveillance efforts.3

Third-party source publications:

1. Kirstein, O.D., et al. (2017). "Minimally invasive microbiopsies: a novel sampling method for identifying asymptomatic, potentially infectious carriers of Leishmania donovani." Int J Parasitol 47(10-11): 609-616.

2. Owen, S.I., et al. (2021). "Evaluation of qPCR on blood and skin microbiopsies, peripheral blood buffy coat smear, and urine antigen ELISA for diagnosis and test of cure for visceral leishmaniasis in HIV- coinfected patients in India: a prospective cohort study." BMJ Open 11(4): e042519.

3. Churiso,G.,et al. (2020). "Minimally Invasive Microbiopsies as an Improved Sampling Method for the Diagnosis of Cutaneous Leishmaniasis." Open Forum Infect Dis 7(9): ofaa364.

 

See the complete publication list here

 

ethical and medical considerations for improving patient comfort

taking a micro skin sample outside the clinical.Minimizing patient discomfort is a pivotal ethical consideration in medical research. The Harpera Microbiopsy Punch can improve the patient experience while ensuring a quick, painless, non-scarring skin sampling experience. This is especially critical in studies involving vulnerable populations or in conditions like HIV. Study participants are more likely to consent to repeated sampling when it's non-invasive. Thus, the potential of Microbiopsy procedures to enable more accessible studies represents a future paradigm shift in public health management.

challenges in adopting new biopsy technologies

The logistical benefits of Microbiopsy are significant in the context of infectious diseases, particularly in low-income countries. However, cost remains a critical factor. Current pricing models for the Harpera device and any associated genetic tests of skin samples are prohibitive for widespread adoption in low-income regions.

Efforts are underway to develop cost-effective tests, such as Recombinase polymerase amplification (RPA) or Loop-mediated isothermal amplification (LAMP) assays, which could revolutionize field diagnostics by reducing costs and enabling remote testing.

Currently, the Harpera is mainly utilized within funded research groups, highlighting the need for price adjustments to make this innovative device accessible for broader public health applications. Adoption of new biopsy technologies like the Harpera Microbiopsy Punch face several challenges:

  • Understanding Microbiopsy Potential:  A more comprehensive understanding of the range of applications for Microbiopsy is needed, particularly concerning the adequacy of the skin specimen material for detecting bacterial, viral, fungal DNA, among others.

  • Workflow Standardization: Success in one research setting doesn't guarantee reproducibility or cost-efficiency elsewhere, highlighting the need for standardized procedures that are adaptable globally.

  • Cost and Awareness: The primary market for infectious disease applications in low-income regions requires affordable solutions, not just for the biopsy procedure itself, but also for the necessary analytical tests.

  • Educational Gaps: Dermatologists and other healthcare providers need greater exposure to the benefits and interpretations of molecular tests compared to traditional histopathology reports.

These factors underscore the need for ongoing education, cost management, and technological refinement to ensure that new biopsy methods like Microbiopsy using the Harpera device can be effectively integrated into global health strategies.

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