Biopsy Procedures

Biopsy Procedures

While dermatologists are able to diagnose many types of skin lesions just by looking at them, certain skin conditions need a more detailed analysis called a biopsy (a dermatologist will surgically remove a small portion of your skin to be further analyzed)

The type of biopsy you are being recommended will depend on the location, size, and depth of the skin lesion:

• A shave biopsy removes a sample from the top layers of skin with a razor blade or scalpel (a small cutting blade used for surgery). Your provider will do a shave biopsy if your condition appears to involve only the top layers of the skin.
• A punch biopsy uses a special tool with a round blade to remove the skin sample. Your provider will do a punch biopsy if your condition appears to involve the deep layers of skin.
• An excisional biopsy uses a scalpel to remove all of the skin lesions, usually with some normal skin around it. The sample may include the full thickness of the skin along with fat below the skin.

While the word biopsy in itself is a scary word for most of patients, mainly due to it being associated with cancer, it is good to know that your doctor might opt for a biopsy to help diagnose a variety of inflammatory skin conditions as well

Once the biopsy is done (15-20 min), the dermatologist will send it to a lab, where a doctor will examine it under a microscope. After making the diagnosis, a dermatopathologist writes a report that explains the medical findings. Your dermatologist will review this report to determine if you need further treatment and will call you to discuss it with you. Typically, it will take 5 to 7 days from the biopsy till the report is issued.

Why do I need a skin biopsy?

You may need a skin biopsy if you have certain skin symptoms, such as:

• A rash that doesn’t go away
• Scaly or rough skin
• Open sores that won’t heal
• A mole or skin growth that has changed in its shape, color, or size
• A mole or new growth that has the “A-B-C-D-Es” of melanoma:
  • Asymmetrical– the shape is not regular
  • Border– the edge is jagged
  • Color– the color is uneven
  • Diameter– the size is larger than a pea
  • Evolving– the mole or growth has changed in the past few weeks or months
• Blistering skin, which may be a sign of pemphigus, an autoimmune disease

What to expect when going for a biopsy:

1. Before the biopsy: Discuss with your doctor if you need to take any special steps to prepare for it. Sometimes, if the patient is on certain medication (ex: blood thinner), the dermatologist might advise to stop the medication few hours prior to the procedure.

2. During the procedure:The biopsy is being done under local anesthesia and will take 15 minutes. Your dermatologist will give you an injection to numb the area. While your dermatologist is injecting, you may feel some burning or stinging. Once the area has been numbed, your dermatologist will proceed to remove a portion of the affected skin. If you had either a punch or excision biopsy, your dermatologist may close the wound with stitches.

3. After procedure care: You need to keep the wound covered for as long as your dermatologist recommends.

In all cases, recovery is very fast and painless, and the scarring is usually minimal.