Skin Biopsy
What is a skin biopsy?
Biopsy is the main method of diagnosing some form of infection or cancer in the body.
During the procedure, a small amount of tissue is removed for microscopic examination through different techniques.
Objective of the exam
In this type of biopsy, cells or skin samples are removed for laboratory analysis.
They look for conditions or diseases and, in many cases, it serves to diagnose or rule out affectations, such as psoriasis or skin cancer.
It is indicated when there are doubts about the clinical diagnosis and is mandatory if a tumor mass of tissue, whether malignant or benign, is suspected.
It is also carried out for therapeutic, research or teaching purposes.
The following are some diseases that may be detected with this procedure:
- Disorders that cause blisters on the skin.
- Psoriasis and eczema.
- Inflammatory affectations.
- Skin cancer, such as carcinomas and melanomas.
- Fungal or bacterial infections.
- Warts.
- Suspicious moles or other tumors.
- Mezquinos (skin tags).
- Actinic keratosis (thick, scaly plaque that can develop into cancer and occurs in areas exposed to the sun).
Do you need this type of biopsy?
If the following symptoms occur, it is important to seek specialized advice:
- Constant and persistent rash.
- Open wounds.
- Rough or scaly skin.
- Mole or growths on the skin that are abnormally colored or irregular in size.
The main types of skin biopsy
Most procedures can be done in the doctor’s office or in an outpatient center.
The way the biopsy is done depends on the size, location, and type of lesion (lump, sore, or an area with an abnormal coloration).
The main types are as follows.
Shave biopsy
The doctor uses a razor or small blade to remove or scrape the top layers of skin (epidermis and a small portion of dermis).
- The whole lesion or only part of it may be removed.
- The procedure may leave a small sunken area, but it will not require stitches.
- It is usually used to diagnose skin cancer or when there is a rash apparently limited to the surface of the skin.
Punch biopsy
Also known as puncture or punch.
In this case, a circular instrument, similar to cookie cutters, is used to extract a cylindrical sample from the deepest layers of the skin (epidermis, dermis, and superficial fat).
- The size that is removed is about the size of a pencil eraser or a bean.
- If immunological involvement is suspected, more than one biopsy is likely to be performed. One is examined under a microscope and another is bacteriologically evaluated (skin culture).
- The removal may cover all or part of the lesion, so you may need stitches in the area.
- It is very common to diagnose skin infections.
Excisional biopsy
The doctor uses a scalpel to remove the entire lesion.
This can include deep layers of skin and oil, as abnormal skin and a portion of normal skin are removed.
- The affected area is closed with sutures.
- In larger areas, the surgeon may use a skin graft or flap to replace the removed skin.
- In cases of melanoma it is a very useful technique.
Surgical biopsy
In this type, a large sample of the lesion is collected.
The piece is divided into a portion and sent to the microbiology lab for examination.
- It regularly requires sutures.
- After diagnosis, skin growth can be treated.
- It is usually done to diagnose ulcers or skin diseases that affect nearby tissue, such as fatty tissue.
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During the biopsy
Your doctor cleans and sanitizes the extraction site and injects you with an anesthetic to prevent pain.
Then, the steps are followed based on the type of biopsy required.
The procedure is usually safe and quick, although bleeding, bruising, scarring, or infection may occasionally occur.
Despite these possible drawbacks, it is always better to go to the oncologist than to allow the disease to evolve.
Should I prepare for the test?
No special preparation is required for this biopsy.
However, it’s a good idea to let your doctor know if you have any of the following conditions:
- Some type of allergy, whether to anesthetics, antibiotics, antiseptics, or even duct tape.
- Clotting problems.
- Treatment with any medicines, such as aspirin, warfarin, or heparin.
- Intake of food supplements or homeopathic medicines.
- A history of skin infections such as impetigo.
What to do after your skin biopsy?
Your doctor will recommend keeping the bandage over the removal site for at least 24 hours.
It is normal for some light bleeding to occur that stops when pressure is applied for 10 minutes.
If bleeding continues, call your doctor.
All biopsies can leave a small scar, especially if the biopsy is done on the neck, back, or chest.
However, the scars fade progressively over time.
Avoid skin-stretching activities, bumps, and wet activities such as pools, hot tubs, or bathtubs until your doctor tells you to.
Generally, healing is complete after two months, although it may take longer in some areas, such as the legs or feet.
To wash the wound, take the following steps:
- Always wash your hands with soap and water before touching the biopsy site.
- Wash the wound at least once a day.
- Rinse thoroughly.
- Pat dry with a clean towel.
- When the area is dry, apply a layer of petroleum jelly
- Cover the site with an adhesive bandage for the first few days.
- Maintain care until the stitches are removed or the skin heals.
These are general guidelines.
The doctor will provide information for specific care in case of sutures, grafts or flaps, if any.
See your specialist if you have signs of infection, such as more swelling, pain, fever, or drainage.
Skin biopsy is one of the most valuable complementary examinations, as it contributes to dermatological examination and is irreplaceable for the study of tumours.
Doing the test early can prevent future complications.
