Skin lesion biopsy

Definition

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

How the test is performed

There are several methods for performing skin biopsies. Most procedures can be easily completed in outpatient medical offices. Choice of techniques is determined by several factors, including the location, size, and type of lesion to be biopsied. All methods should include local injection or topical application of an anesthetic.

The least invasive technique, the shave biopsy, involves the removal of superficial levels of skin. This type of biopsy does not require the use of sutures (stitches).

Punch biopsies are most often used for deeper skin lesions. A small cylinder of skin (usually the size of a pencil eraser) is removed with a sharp, hollow instrument. If a large sample is taken, the area may be closed with stitches.

In an excisional biopsy, the entire clinical lesion is removed. A local anesthetic is injected. Then the entire lump, spot, or sore is removed, going as deep as necessary to get the entire area. The incision is then closed with stitches. Bleeding is controlled by pressure. If a large area is biopsied, a skin graft or flap of normal skin may be used to replace it.

How to prepare for the test

You must understand the risks, benefits, and alternatives explained to you by your physician before giving consent to any procedure. Please provide detailed information to your doctor about any allergies you have, medications you are taking (including vitamins and supplements, herbal remedies, and over-the-counter preparations), or if you have bleeding problems or are pregnant.

How the test will feel

There is a brief prick and sting as the anesthetic is injected. Afterward, the area may be tender.

Why the test is performed

The test is used to identify cancers and benign growths, to help diagnose chronic bacterial and fungal skin infections, and to identify other skin conditions.

What abnormal results mean

The test may reveal skin cancers or benign (noncancerous) conditions. Bacteria and fungi can be identified. The test may also reveal some inflammatory diseases of the skin.

What the risks are

Any time the skin barrier is broken, there is a chance of infection. If you tend to form large scars (keloids) in response to a skin injury, there is a fair chance one will form over the biopsy area. You may lose a very small amount of blood during the procedure.

Special considerations

Fluid-filled lesions may be examined by skin lesion aspiration instead of skin lesion biopsy.

Illustrations

Viral lesion culture

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