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Skin lesion biopsy

Definition

A skin lesion biopsy is the removal of a piece of suspected abnormal skin to diagnose or rule out an illness.

Alternative Names

Punch biopsy; Shave biopsy; Skin biopsy; Biopsy - skin

How the Test is Performed

There are several ways to do a skin biopsy. Most procedures are easily done in your doctor's office or an outpatient medical office.

Which procedure you have depends on the location, size, and type of lesion. A lesion is an abnormal area of the skin. This can be a lump, sore, or an area of skin color that is not normal.

You will receive some type of numbing medicine (anesthetic) before any type of skin biopsy. Types of skin biopsies are described below.

Shave Biopsy

A shave biopsy is the least invasive method. Your doctor uses a small blade to remove the outermost layers of skin. The area removed includes all or part of the lesion. You do not need stitches. At the end of the procedure, medicine is applied to the area to stop any bleeding.

Punch Biopsy

A punch  biopsy is most often used for deeper skin lesions. Your doctor uses a skin punch tool to remove a small round piece of skin. The area removed is about the size of a pencil eraser. It includes all or part of the lesion. Medicine is put on the area to stop any bleeding. Often, the area is closed with stitches.

Excisional Biopsy

An excisional biopsy is usually done by a surgeon. During the procedure, the entire lesion is removed. Numbing medicine is injected into the area. The entire lesion is removed, going as deep as needed to get the whole area. The area is closed with stitches. If a large area is biopsied, a skin graft or flap of normal skin may be used to replace the skin that was removed.

Incisional Biopsy

An incisional biopsy takes only a piece of a large lesion for examination. Numbing medicine is injected into the area. A piece of the growth is cut and sent to the lab for examination. You may have stitches, if needed. The rest of the growth can be treated after the diagnosis is made.

How to Prepare for the Test

Tell your health care provider:

  • About the medicines you are taking, including vitamins and supplements, herbal remedies, and over-the-counter medicines
  • If you have any allergies
  • If you have bleeding problems
  • If you are or think you might be pregnant

Follow your health care provider's instructions on how to prepare for the biopsy.

How the Test will Feel

There is a brief prick and sting as the anesthetic is injected. The biopsy area may be tender for a few days afterward.

Why the Test is Performed

Your doctor may order a skin biopsy if you have signs or symptoms of:

  • Chronic or acute skin rashes
  • Noncancerous (benign) growths
  • Skin cancer
  • Other skin conditions

Normal Results

A normal result means that the skin area that was removed is healthy. Doctors call this a negative biopsy result.

What Abnormal Results Mean

The test may reveal skin cancer or a noncancerous (benign) condition. Bacteria and fungi can be identified. The test may also reveal some types of inflammatory skin diseases. Once the diagnosis is confirmed with the biopsy, a treatment plan is usually started.

Risks

Risks of a skin biopsy may include:

You will bleed slightly during the procedure. Tell your doctor if you have a history of bleeding problems.

References

Affleck AG, Colver G. Skin biopsy techniques. In: Robinson JK, Hanke CW, Siegel DM, Fratila A, eds. Surgery of the Skin: Procedural Dermatology. 2nd ed. Philadelphia, Pa: Elsevier Mosby; 2010:chap 11.

Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 27.


Review Date: 9/20/2013
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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