The “Christmas notch”: a novel use for the punch biopsy blade
Authors: George Rahmani and John L Kelly
Published online: 11 December 2017
The punch biopsy blade consists of a hollow circular blade at the end of a pencil-like handle. It is an instrument often found in the armamentarium of your friendly neighbourhood dermatologist. It was first developed by Keyes1 in 1887, and has since been described as having diagnostic, therapeutic and cosmetic uses.2-4 The sharp, circular blade allows the clinician to take a small, predetermined piece of tissue (ranging from 0.5 to 10 mm5), which can subsequently be sent for histopathological analysis. The authors have discovered that the unique shape of the punch biopsy blade also makes it a useful tool for cutting a new notch in a leather belt.
The busy lifestyle of doctors often means skipping meals during the day, and suddenly they can find that their trousers have become a little bit too loose. If their belt is already fastened at the final notch, this can prove to be problematic and potentially embarrassing in front of their peers. At this time of year, the converse may also be true. The holiday season brings with it a level of self-indulgence and merriment, which can leave one running out of belt holes. By using a punch biopsy blade, a new, clean and perfectly round notch can be created in the leather belt in a matter of seconds (Figure).
While neither groundbreaking nor particularly cost effective, the authors feel that this novel use of a punch biopsy blade is so quick, easy and effective that it is worth sharing with those plagued by loose trousers, or indeed belts that require that extra “Christmas notch”.
Competing interests
References
- The cutaneous punch by Edward L. Keyes (J Cutan Genitourin Dis, March 1887). Arch Dermatol 1982; 118: 940-942.
- Chavez-Frazier AE, Wanitphakdeedecha R, Nguyen TH, Chen TM. Introducing the string-of beads biopsy: solving diagnostic challenges of the skin with punch biopsies for multiple studies, simple closure. Dermatol Surg 2008; 34: 1549-1552.
- Dinehart SM, Herzberg AJ, Kerns BJ, Pollack SV. Acne keloidalis: a review. J Dermatol Surg Oncol 1989; 15: 642-647.
- Tursen U, Kaya TI, Ikizoglu G. Surgical approach to benign small papular and dome-shaped melanocytic naevi on the face. J Cosmet Dermatol 2003; 2: 175-179.
- Hurkudli DS, Sarvajnamurthy S, Suryanarayan S, Chugh VS. Novel uses of skin biopsy punches in dermatosurgery. Indian J Dermatol 2015; 60: 170-175.
Provenance: Not commissioned; not externally peer reviewed.
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