The “Christmas notch”: a novel use for the punch biopsy blade

George Rahmani and John L Kelly
Med J Aust 2017; 207 (11): . || doi: 10.5694/mja17.00606
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.

  • 1 University Hospital Galway, Galway, Ireland
  • 2 National University of Ireland, Galway, Ireland


Competing interests:

No relevant disclosures.

  • 1. The cutaneous punch by Edward L. Keyes (J Cutan Genitourin Dis, March 1887). Arch Dermatol 1982; 118: 940-942.
  • 2. 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.
  • 3. Dinehart SM, Herzberg AJ, Kerns BJ, Pollack SV. Acne keloidalis: a review. J Dermatol Surg Oncol 1989; 15: 642-647.
  • 4. 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.
  • 5. Hurkudli DS, Sarvajnamurthy S, Suryanarayan S, Chugh VS. Novel uses of skin biopsy punches in dermatosurgery. Indian J Dermatol 2015; 60: 170-175.


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