Skin Biopsy

(Skin Lesion Biopsy; Shave Biopsy; Punch Biopsy; Excision Biopsy)

Definition

A skin biopsy is a procedure where a small piece of abnormal skin is removed for testing. There are three main types of skin biopsies:
  • Shave biopsy—outer part of affected area is removed
  • Punch biopsy—a small cylinder of skin is removed using a punch tool
  • Excisional biopsy—an entire area of abnormal skin is removed
Punch Biopsy
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Reasons for Procedure

A skin biopsy is used to test an area of abnormal skin. If possible the entire area will be removed during biopsy. A skin biopsy may be done to diagnose:
  • Bacterial, viral, or fungal infections
  • Cancer or benign skin growths
  • Inflammatory skin disorders, such as psoriasis
Skin biopsy may also be done to:
  • Make sure a tumor was completely removed—by testing remaining skin
  • Monitor the effect of a treatment

Possible Complications

Complications are rare. However, no procedure is completely free of risk. If you are planning to have a skin biopsy, your doctor will review a list of possible complications such as:
  • Bleeding
  • Infection
  • Poor wound healing
  • Scarring
  • Nerve damage
Factors that may increase the risk of complications include:
  • Smoking
  • Immunosuppression
  • Bleeding disorders
  • Circulatory problems

What to Expect

Prior to Procedure

No special preparation is needed for this procedure.

Anesthesia

Local anesthesia may be used. It will numb the area being treated.

Description of the Procedure

The involved area will be prepared. The skin will be cleaned. Medicine will be applied to the skin or injected to numb the area. The exact steps will depend on the type of biopsy:
  • Shave biopsy—A thin slice of the skin will be removed. It is done with a special razor that "shaves" off a piece of skin.
  • Punch biopsy—A special tool is used. The tip of the tool is pushed into your skin. As it is pushed down, the tool will be rotated into the skin. A circular sample of skin will then be cut free. This biopsy provides a sample from all of the layers of the skin. Stitches may be needed to close the hole.
  • Excision biopsy—The entire area of abnormal skin will be removed with a scalpel. This biopsy will make a larger and deeper hole in the skin. Stitches will be placed to close the hole left in the skin.
After the procedure, a clean dressing will be placed over the area.

How Long Will It Take?

5-20 minutes

Will It Hurt?

There may be some pain and discomfort after the procedure. Your doctor will recommend medication to minimize this discomfort.

Post-procedure Care

Keep the biopsy area clean and dry. Keep it covered with a sterile bandage for 1-2 days. Stitches will be left in the skin for 3-14 days, depending on where they are located. Ask your doctor when you can expect the results of the biopsy.
Ask your doctor about when it is safe to shower, bathe, or soak in water. Pat the wound dry after you have washed it with a mild soap.
Be sure to follow your doctor's instructions.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Pain that you cannot control with the medicines you have been given
  • Any new symptoms
In case of an emergency, call for medical help right away.

RESOURCES

American Society for Dermatologic Surgery http://www.asds.net

National Cancer Institute http://www.cancer.gov

CANADIAN RESOURCES

Canadian Dermatology Association http://www.dermatology.ca

Cancer Care Ontario http://www.cancercare.on.ca

References

Pickett H. Shave and punch biopsy for skin lesions. Am Fam Physician. 2011;84(9):995-1002.

Skin biopsy. Nemours Kidshealth website. Available at: http://kidshealth.org/teen/your%5Fbody/skin%5Fstuff/skin%5Fbiopsy.html. Updated July 2012. Accessed March 28, 2013.

Skin biopsy. DermNet NZ website. Available at: http://www.dermnetnz.org/procedures/biopsy.html. Updated April 14, 2012. Accessed March 28, 2012.

6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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