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skin biopsy
Indications:
Punch biopsy:
1) bullous, superficial inflammatory & granulomatous diseases
2) benign tumors (skin neoplasm)
3) nonmelanocytic malignant tumors (skin cancer)
Exisional biopsy:
1) suspected malignant melanoma
2) atypical pigmented lesions
3) deep inflammatory diseases
Shave biopsy
- raised non-melanocytic lesions
Procedure:
Punch biopsy:
- 2-10 mm punches; 3 mm is optimal in most cases
- suturing not necessary for 4 mm punch biopsy of trunk or extremity; suturing may be indicated for larger punch biopsies or biopsies on the head or neck [2]
Place biopsy specimen in a preservative & send for pathology evaluation.
Notes:
Avoid:
1) areas at higher risk of infection
a) groin
b) axilla
2) face or other areas of cosmetic concern
3) lower leg (frequent site of chronic inflammatory change)
4) lesions with crusting, excoriation, erosions or evidence of secondary infection
Related
skin
Specific
lip biopsy
nuchal skin biopsy
General
tissue biopsy
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Christenson LJ, Phillips PK, Weaver AL, Otley CC.
Primary closure vs second-intention treatment of skin punch
biopsy sites: a randomized trial.
Arch Dermatol. 2005 Sep;141(9):1093-9.
PMID: 16172305
- Tran KT, Wright NA, Cockerell CJ.
Biopsy of the pigmented lesion--when and how.
J Am Acad Dermatol. 2008 Nov;59(5):852-71
PMID: 18762353
- Elston DM, Stratman EJ, Miller SJ.
Skin biopsy: Biopsy issues in specific diseases.
J Am Acad Dermatol. 2016 Jan;74(1):1-16;
PMID: 26702794