This document discusses diagnostic tests for the integumentary system including biopsies, microscopic tests, and allergen sensitivity tests. It describes different types of biopsies like punch, incisional, and excisional biopsies that are used to differentiate benign and malignant skin lesions. Microscopic tests include potassium hydroxide, Tzanck test, cultures, mineral oil slides, and immunofluorescent slides to identify fungal, bacterial, viral infections and conditions like herpes and pemphigus vulgaris. Additional tests covered are Wood's lamp to detect pseudomonas and fungi, and patch and scratch tests to determine specific allergens. The nurse's role is to explain procedures, assist where needed, and

1. DIAGNOSTIC TEST
(INTEGUMENTARY)
Presented by: Kinjal Rathod
Nursing tutor

2. Biopsy
a) Punch skin biopsy, incisional skin biopsy and
excisional skin biopsy are done. Purpose of biopsy is
to differentiate benign lesions from skin cancers.
Punch skin biopsy-Special instrument used to remove
small section of dermis & fat.
Incisional biopsy- Incision is made and part of lesion or
tumor is removed. In Excisional biopsy- Entire skin
lesion & tumor is removed for analysis.

4. B) Shave skin biopsy-
• This is done to differentiate infections from inflammatory
lesion.Single edged razor is used to take biopsy.

6. Nursing care
1. Explain the procedure to the
patient. - Assist in procedure.-
Apply dressing and provide
information about self-care and
removal of dressing.- Document
procedures.

7. Microscopic test
• A) Potassium hydroxide (KOH): It is done to rule out fungal
infection of hair and nail.
• B) Tzanck test: (Wright’s and Giemsa’s stain) – This test done
to rule out herpes infections.From lesions.
• C) Culture: Culture is done to rule out bacterial, viral and fungal
infections. Sample is takenfrom lesion, from drainage and
exudate from lesions.
• D) Mineral oil slides: It determine the skin infestations.

8. • E) Immunofluorescent slides: Test is done to identify IgG
antibodies (present in pemphigus vulgaris) and varicella in skin
cells (Herpes zoster). Skin and blood samples are taken.

9. Nursing
responsibility
for
microscopic
tests
1. EXPLAIN THE
PROCEDURE TO
PATIENT.
2. ASSIST IN
OBTAINED
SAMPLES.
3. DOCUMENT
PROCEDURE &
SEND TO LAB.

10. Wood's lamp
• Skin is examined under ultra violet light that causes certain
fluorescence (pseudomonas & fungi).
• Nurse's role - Explain the procedure to patient & document the
procedure.

11. Patch test, scratch test
These tests are used to determine specific allergen.
Role of nurse: Explain procedure to patient and tell the patient to
come back after 48 hours for evaluation of patched or scratched
skin. Document procedure