Clinical Hours: Mon-Fri, 8AM - 3PM(905) 493-5700
1885 Glenanna Road, Suite 220, Pickering, ON, L1V 6R6
An overview of the main types of diagnostic skin biopsy, including punch, shave, incisional, and excision biopsy, along with associated risks and healing times.
Excisional biopsy is the term used for describing the removal of skin lesion(s) by completely cutting them out of the affected site. The procedure is usually performed under local anaesthetic that is injected into the skin to numb the area. The injection causes a brief stinging sensation. After the procedure is completed, a suture or dressing may be applied to the biopsy site.
There are different types of skin biopsies: punch biopsy, shave biopsy, curettage, incisional biopsy, and excision biopsy.
A punch biopsy is considered to be the most useful type of biopsy. It is quick to perform, convenient, and leaves a small wound. The skin sample is of full thickness, which enables the pathologist to obtain a good overall view of the epidermis, dermis, and subcutis.
A disposable skin biopsy punch is used to perform this procedure. The instrument has a round stainless steel blade ranging from 2 to 6 mm in diameter, with the most common sizes being 3 and 4 mm. The instrument is held perpendicular to the skin and rotated to pierce the skin. The skin sample is subsequently removed with the assistance of forceps and scissors.
Shave biopsy is used for superficial skin lesions in order to confirm a diagnosis such as basal cell carcinoma. A tangential shave of the skin is performed with a scalpel, a specialised shave-biopsy instrument, or a razor blade. Stitches are not required, and the wound typically heals within one to three weeks.
A skin curette is used for scraping off a superficial skin lesion, such as seborrhoeic keratosis. It is important to note that the samples obtained through curettage are not used for determining whether a lesion has been removed completely.
Incisional biopsy is used for removing larger and deeper portions of skin with the use of a scalpel blade. Stitches are required following this procedure.
Excision biopsy is used for the complete removal of skin lesions such as skin cancer. A margin of surrounding skin is included to improve the chances of complete cancer removal. Smaller lesions are removed with a scalpel blade, while larger lesions may be addressed with a skin flap, which involves moving adjacent skin over the wound site, or a graft, in which skin is taken from another site to patch the wound.
Skin biopsy is generally a straightforward procedure, and the chances of post-procedure complications are uncommon. However, the larger the area of skin removed, the greater the likelihood of possible complications.
Intraoperative and postoperative bleeding can occur in any patient. Bacterial wound infection occurs in approximately one to five percent of excision biopsies and is uncommon in small punch, shave, or incisional biopsies. The site of the biopsy, the presence of ulcerated or crusted skin lesions, older age, diabetes, or the use of immunosuppressive medications may increase the risk of wound infection.
Permanent scarring as a result of a biopsy is relatively common. Certain body sites, such as the centre of the chest, are prone to the development of excessive or hypertrophic scars.
After a biopsy is completed, the sample is sent to a pathology laboratory. Results are typically available within one to two weeks.
Your feedback helps us improve our news and clinical insights
From medical dermatology to surgical procedures, our clinic provides comprehensive care for all skin, hair, and nail conditions.