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Skin Biopsy

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What is a skin biopsy?

A skin biopsy is a procedure that removes a small sample of skin for testing. The skin sample is looked at under a microscope to check for skin cancer, skin infections, or skin disorders such as psoriasis.

There are three main ways to do a skin biopsy:

  • A punch biopsy, which uses a special circular tool to remove the sample.
  • A shave biopsy, which removes the sample with a razor blade
  • An excisional biopsy, which removes the sample with small knife called a scalpel.

The type of biopsy you get depends on the location and size of the abnormal area of skin, known as a skin lesion. Most skin biopsies can be done in a health care provider’s office or other outpatient facility.

Other names: punch biopsy, shave biopsy, excisional biopsy, skin cancer biopsy, basal cell biopsy, squamous cell biopsy, melanoma biopsy

What is it used for?

A skin biopsy is used to help diagnose a variety of skin conditions including:

  • Skin disorders such as psoriasis and eczema
  • Bacterial or fungal infections of the skin
  • Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancerous.

Skin cancer is the most common type of cancer in the United States. The most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and are usually curable with treatment. The third type of skin cancer is called melanoma. Melanoma is less common than the other two, but more dangerous because it’s more likely to spread. Most skin cancer deaths are caused by melanoma.

A skin biopsy can help diagnose skin cancer in the early stages, when it’s easier to treat.

Why do I need a skin biopsy?

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

  • A persistent rash
  • Scaly or rough skin
  • Open sores
  • A mole or other growth that is irregular in shape, color, and/or size

What happens during a skin biopsy?

A health care provider will clean the site and inject an anesthetic so you won’t feel any pain during the procedure. The rest of the procedure steps depend on which type of skin biopsy you are getting. There are three main types:

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Punch biopsy

  • A health care provider will place a special circular tool over the abnormal skin area (lesion) and rotate it to remove a small piece of skin (about the size of a pencil eraser).
  • The sample will be lifted out with a special tool
  • If a larger skin sample was taken, you may need one or two stitches to cover the biopsy site.
  • Pressure will be applied to the site until the bleeding stops.
  • The site will be covered with a bandage or sterile dressing.

A punch biopsy is often used to diagnose rashes.

Shave biopsy

  • A health care provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
  • Pressure will be applied to the biopsy site to stop the bleeding. You may also get a medicine that goes on top of the skin (also called a topical medicine) to help stop the bleeding.

A shave biopsy is often used if your provider thinks you may have skin cancer, or if you have a rash that’s limited to the top layer of your skin.

Excisional biopsy

  • A surgeon will use a scalpel to remove the entire skin lesion (the abnormal area of skin).
  • The surgeon will close the biopsy site with stitches.
  • Pressure will be applied to the site until the bleeding stops.
  • The site will be covered with a bandage or sterile dressing.

An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer.

After the biopsy, keep the area covered with a bandage until you’ve healed, or until your stitches come out. If you had stitches, they will be taken out 3–14 days after your procedure.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for a skin biopsy.

Are there any risks to the test?

You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or they get worse, talk to your health care provider.

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What do the results mean?

If your results were normal, it means no cancer or skin disease was found. If your results were not normal, you may be diagnosed with one of the following conditions:

  • A bacterial or fungal infection
  • A skin disorder such as psoriasis
  • Skin cancer. Your results may indicate one of three types of skin cancers: basal cell, squamous cell, or melanoma.

Is there anything else I need to know about a skin biopsy?

If you are diagnosed with basal cell or squamous cell cancer, the entire cancerous lesion may be removed at the time of the skin biopsy or soon after. Often, no other treatment is needed. If you are diagnosed with melanoma, you will need more tests to see if the cancer has spread. Then you and your health care provider can develop a treatment plan that’s right for you.

References

  1. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2018. What Are Basal and Squamous Cell Skin Cancers?; [updated 2016 May 10; cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html
  2. American Society of Clinical Oncology [Internet]. Alexandria (VA): American Society of Clinical Oncology; 2005–2018. Skin Cancer: (Non-Melanoma) Diagnosis; 2016 Dec [cited 2018 Apr 13]; [about 8 screens]. Available from: https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/diagnosis
  3. American Society of Clinical Oncology [Internet]. Alexandria (VA): American Society of Clinical Oncology; 2005–2018. Skin Cancer: (Non-Melanoma) Introduction; 2016 Dec [cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/introduction
  4. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; What is Skin Cancer?; [updated 2017 Apr 25; cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.cdc.gov/cancer/skin/basic_info/what-is-skin-cancer.htm
  5. Johns Hopkins Medicine [Internet]. Baltimore: The Johns Hopkins University; Health Library: Biopsy; [cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/pathology/biopsy_85,p00950
  6. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Skin Biopsy; 2017 Dec 29 [cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/skin-biopsy/about/pac-20384634
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2018. Diagnosis of Skin Disorders; [cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.merckmanuals.com/home/skin-disorders/biology-of-the-skin/diagnosis-of-skin-disorders
  8. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Melanoma Treatment (PDQ®)—Patient Version; [cited 2018 Apr 13]; [about 4 screens]. Available from: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq
  9. PubMed Health [Internet]. Bethesda (MD): National Center for Biotechnology Information, U.S. National Library of Medicine; What happens during a skin examination?; [updated 2016 Jul 28; cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0088932
  10. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida; c2018. Skin lesion biopsy: Overview; [updated 2018 Apr 13; cited 2018 Apr 13]; [about 2 screens]. Available from: https://ufhealth.org/skin-lesion-biopsy
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Skin Tests; [cited 2018 Apr 13]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid;=P00319
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Skin Biopsy: How It Is Done; [updated 2017 Oct 9; cited 2018 Apr 13]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/skin-biopsy/hw234496.html#aa38030
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Skin Biopsy: Results; [updated 2017 Oct 9; cited 2018 Apr 13]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/skin-biopsy/hw234496.html#aa38046
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Skin Biopsy: Risks; [updated 2017 Oct 9; cited 2018 Apr 13]; [about 7 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/skin-biopsy/hw234496.html#aa38044
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Skin Biopsy: Test Overview; [updated 2017 Oct 9; cited 2018 Apr 13]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/skin-biopsy/hw234496.html
  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Skin Biopsy: Why It Is Done; [updated 2017 Oct 9; cited 2018 Apr 13]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/skin-biopsy/hw234496.html#aa38014
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