Biopsy is a procedure in which a small fragment of the skin or mucosa is removed for pathological analysis in order to diagnose a dermatological disease or tumor. It is performed in the office under local anesthesia. There are different techniques for performing skin biopsy. The choice of the different techniques is dependent on the suspected diagnosis of the skin lesion. The skin fragment is sent to the pathologist, who issues a report with the microscopic diagnosis of the lesion.
The postoperative care indicated by the dermatologist is very important to facilitate healing and prevent infections.
The most used Biopsy techniques are:
• Punch: a cylindrical device with a cutting surface similar to a pen is used. When rotated, it removes a small column of skin up to the fat layer of the skin. It results in a small wound that is usually sutured.
• Incisional biopsy: It is the partial removal of the lesion and aims only at diagnosis. It can be done using a punch or scalpel, in which larger and deeper skin fragments are removed. It is used to diagnose tumors, blisters, panniculitis or deep inflammatory processes.
• Excisional biopsy: It is the total removal of the lesion with a small margin of normal skin around it. It is the only biopsy technique where the analysis of surgical margins can be done safely. Indicated for tumors and melanocytic lesions. The excision is usually performed in a fusiform or ellipse format to allow a more cosmetically appropriate scar.