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.
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