Consult Immunopathology for specific instructions prior to beginning the procedure. Biopsy of skin or mucosa must be kept moist on saline soaked gauze in petri dish or placed in Zeus Tissue Fixative (ZTF). Take skin biopsies from the following sites: If pemphigus or bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid, linear IgA disease, Epidermolysis bullosa acquisita, or Herpes gestationis is suspected, take a 4 mm biopsy from skin adjacent to the bullae. Repeated biopsies are sometimes necessary to confirm dermatitis herpetiformis. If ocular pemphigoid is suspected, take a 4 mm punch biopsy from normal buccal mucosa or ocular conjunctiva. If systemic lupus erythematosus (SLE) or discoid LE (DLE) is suspected, take biopsy from lesional skin. To differentiate between SLE and DLE, take biopsy from nonlesional nonsunexposed site such as deltoid. This biopsy which is called a lupus band test will often be positive in SLE, but should always be negative in DLE. If cutaneous vasculitis is suspected, take a 4 mm punch biopsy in a new lesion of less than 24 hours duration or adjacent normal skin. If immunomapping is desired for diagnosing hereditary epidermolysis bullosa, take a biopsy of a new lesion or a pencil eraser-induced lesion. Place biopsy material immediately into saline soaked gauze to prevent dehydration or into vial containing holding media. Biopsy in saline is to be delivered immediately to laboratory. Specimen in Zeus Tissue Fixative is good for up to 5 days at room temperature. DO NOT ATTEMPT TO FREEZE SPECIMENS PLACED IN ZTF. Cause for Rejection: drying out of specimen, insufficient tissue.