Skin Biopsy

What is a skin biopsy?

A skin biopsy is a procedure that involves taking a small sample of skin for testing, typically to diagnose a skin lesion, which is an abnormal area of skin. The sample is examined under a microscope to detect skin cancer, various skin conditions, or skin infections. Not all skin lesions require a biopsy, as some can be diagnosed visually by your healthcare provider.

There are three primary methods of performing a skin biopsy, chosen based on the location, size, and depth of the lesion:

• Shave biopsy: This method removes a sample from the top layers of skin using a razor blade or scalpel. It is used when the condition seems to affect only the superficial layers of skin.
• Punch biopsy: Employing a special tool with a round blade, this technique extracts a skin sample, particularly when the condition involves deeper skin layers.
• Excisional biopsy: Using a scalpel, this method removes the entire skin lesion along with some normal surrounding skin. The sample may include the full thickness of skin and underlying fat.

What is it used for?

A skin biopsy aids in diagnosing various skin conditions, including:

• Skin disorders like psoriasis, eczema, actinic keratosis (pre-cancers), and warts.
• Bacterial or fungal infections affecting the skin.
• Skin cancer, where a biopsy confirms or rules out cancer in suspicious moles or growths, identifying the specific type of skin cancer.

Skin cancer, the most prevalent cancer in the United States, includes basal cell and squamous cell cancers, which typically remain localized and are often curable with treatment. Melanoma, the most severe type, is more prone to spreading to other organs, leading to most skin cancer-related deaths.

Why do I need a skin biopsy?

A skin biopsy might be necessary if you experience specific skin symptoms, such as:

• Persistent rash.
• Scaly or rough skin patches.
• Non-healing open sores.
• Changes in a mole or skin growth's shape, color, or size.
• Moles or new growths exhibiting characteristics like:
• Asymmetry in shape
• Jagged or irregular borders
• Uneven coloration
• Larger diameter than a pea
• Evolution or changes over time
• Blistering skin, potentially indicating conditions like pemphigus, an autoimmune disorder.

What happens during a skin biopsy?

The provider will cleanse the area and administer an injection to numb the skin, ensuring a painless experience.

Punch biopsy:

• Using a specialized tool with a hollow, round blade, the provider removes a small skin sample, typically the size of a pencil eraser, from the abnormal area.
• The sample is then extracted with another tool.
• If a larger sample is taken, stitches may be required to close the wound.
• Pressure is applied to stop bleeding, followed by bandaging the wound.
• This method is often employed for diagnosing rashes.

Shave biopsy:

• A razor or scalpel is used to remove a sample from the skin's top layer.
• Bleeding is controlled by pressure or applying medication to the wound.
• The wound is bandaged afterward.This type of biopsy is common for suspected basal cell or squamous cell skin cancer or superficial rashes.

Excisional biopsy:

• A scalpel is utilized to remove the entire skin lesion along with some surrounding normal skin ("margin"). For larger lesions, only a portion may be removed, termed an incisional biopsy.
• Stitches are used to close the wound.
• Pressure is applied to stop bleeding, and the wound is bandaged.