Overview of Skin Biopsy
A skin biopsy is a common procedure in skin health that helps doctors diagnose skin problems. There are several different ways to do a skin biopsy, and the best method depends on several factors, like where on the body the biopsy needs to be taken and how deep and wide the sample needs to be. The goal of the biopsy is to gather as much skin tissue as necessary to make a diagnosis, from the place where it’s most likely to provide the most helpful results. However, it’s also important to limit any damage to the patient’s appearance and physical function.
There are two main types of skin biopsies: incisional and excisional. In an incisional biopsy, the doctor only takes a sample of a skin problem area. This can be achieved by shaving, scissors, scraping, or by using a small round blade called a punch. An excisional biopsy, on the other hand, involves the doctor removing the entire visible problem area. This is usually done using a sharp blade to cut through all the layers of skin or with a scoop-like technique.
Why do People Need Skin Biopsy
A biopsy is a procedure doctors use when they need to identify a skin disorder or an internal disease that’s showing up through symptoms in your skin or soft tissues. The doctor will remove a small sample of your skin or tissue for study under a microscope. This procedure is helpful in diagnosing a variety of conditions and guiding treatment decisions. It’s a common and safe process often used to determine the cause of skin changes or to check for diseases inside the body that could be affecting the skin or tissues.
When a Person Should Avoid Skin Biopsy
A skin biopsy, which is a procedure where a small piece of skin is removed and examined, is typically safe for everyone. However, there could be some exceptions. If a person has an allergy to the medicine used to numb the area (local anesthetics), an infection, or a tattoo on the spot where the doctor needs to make a small cut, then these could create some difficulties. In these cases, the doctor needs to take special care.
Before a skin biopsy, the doctor will usually check for any blood-related issues or if a patient is taking blood-thinning medications, or has a history of excessive bleeding. Even if these conditions are present, they usually don’t stop a person from getting a skin biopsy – the doctor just needs to be aware and plan accordingly.
Equipment used for Skin Biopsy
The following items are necessary for the procedure:
Skin Disinfectant: This is typically alcohol, although other substances designed to clean the skin can also be used.
Local Anesthetic: Xylocaine is most commonly used to numb the area. It’s typically mixed with sodium bicarbonate to make the injection less painful.
Gauze: This is a type of bandage used to absorb fluids and protect the wound.
Biopsy Instrument: This could be a biopsy punch, a #15 scalpel blade, a flexible handheld surgical blade or razor blade, or small scissors. The choice of instrument depends on the type of skin condition being treated.
Specimen Fixative: Usually, this is a substance called formalin, but other substances may be needed for specific tests like immunofluorescence (a lab test that uses fluorescence to detect antibodies in a sample) and viral or other cultures.
Hemostatic Agent: This is a substance that stops bleeding. Most commonly, a solution of aluminum chloride is used. However, other agents like Monsel’s ferric subsulfate solution may also be used in certain cases.
Sterile Ointment and Bandage Material: A sterile petrolatum is usually applied to the wound, as it helps prevent infection without causing allergic reactions. This is followed by a non-stick surgical dressing and hypoallergenic tape to cover the wound and aid in healing.
Preparing for Skin Biopsy
Before a biopsy, which is a procedure to take a small sample of tissue for testing, the doctor will first pick the best place for the needle to go in. Next, they’ll clean the skin in this area with alcohol. This helps to lower the number of bacteria on the skin and also wipes away any natural oils. Red spots or growths on the skin can often fade in color when a numbing drug is injected into them. This is why it’s especially important for the doctor to mark these spots before starting the procedure, so they don’t get lost.
How is Skin Biopsy performed
Doctors can diagnose skin conditions and make sure everything’s safe by looking at a small sample of your skin under a microscope. This process is known as a biopsy. There are a few different ways doctors can take this small sample of skin:
1. Shave technique: After cleaning and numbing the skin, your doctor will use a scalpel to remove a small, superficial layer of skin. This is a great way to diagnose non-melanoma skin cancers. But sometimes the cancer can be deeper, and it might not get picked up by this really shallow test.
2. Scissor technique: For smaller bumps on the skin, like skin tags, or for thin, loose skin areas like your eyelids or underarms, your doctor might choose scissors. After cleaning and numbing the area, the doctor will use scissors to carefully remove the bump.
3. Punch biopsy: This technique involves using a special tool that allows doctors to take a deeper sample of skin. It’s usually used when the doctor needs to analyse skin inflammation or small skin lesions. It can also be used in larger pigmented areas that show signs of disease, taking multiple samples from different areas to get a more accurate diagnosis.
4. Wedge biopsy: A sliver of skin tissue is removed from a larger skin growth. If your doctor suspects a growth is a potentially cancerous melanoma, this type of biopsy may be performed.
5. Excisional biopsy: This method removes the entire visible lesion and some tissue beneath it with a scalpel. The removal of a suspected melanoma entirely is often the best technique, as it gives doctors the most information about the depth and severity of the cancer.
After taking a skin sample, your doctor will handle any bleeding and bandage the wound. In the case of a punch or excisional biopsy, stitches might be used to help the wound heal. Ultimately, the purpose of these tests is to provide doctors and pathologists with this important information, improving the likelihood of successful diagnosis and treatment.
Possible Complications of Skin Biopsy
If you’re having a biopsy, it’s normal to be worried about the potential complications, so let’s discuss what they might include:
After the biopsy, you may have some bleeding at the place where the doctor took the sample. You might also get a hematoma, which is simply a fancy term for a bruise or a collection of clotted blood. There is also a small risk of infection developing at the biopsy site.
Don’t worry though, as your doctor will take simple steps to help prevent complications. They will put pressure dressings and apply ice to the biopsy site to lessen the risk of bleeding or forming a hematoma. If the doctor needed to take a larger sample from your tissue, a stitch or two may be necessary to control any bleeding. The rate of infections after such clean procedures is very low, less than 5%. If you are at a higher risk of infection, for any reason, the doctor might give you preventive antibiotics to use.
In rare cases, some patients might have an allergic reaction or a vasovagal response after the procedure. A vasovagal response is a sudden drop in your heart rate and blood pressure, which can make you feel faint. If this happens, the healthcare professionals will quickly reposition you in a way that helps restore normal blood flow.
In summary, although complications can happen, they are generally manageable and healthcare professionals will be prepared to deal with them. The aim is always to minimize risks and ensure that you get safe, effective care.
What Else Should I Know About Skin Biopsy?
Your doctor may need to perform a skin biopsy to help figure out or confirm a diagnosis. This procedure involves taking a small sample of your skin tissue to study it more closely. The purpose is to better understand the cause of a skin growth or rash. Then, the tissue sample will be examined under a microscope in order to understand what’s going on.
The biopsy site, or the area of skin where the biopsy is taken from, will heal on its own, but it might leave a small scar. After a shave biopsy, where the doctor shaves off a small piece of the abnormal skin, the area might crust over, get a scab, and cause mild pain as it heals completely, which usually takes a few weeks. The healed area might end up being lighter or darker than your normal skin color.
Even though this might sound a bit scary, it’s actually a routine procedure. Skin biopsies are relatively low risk and can be performed safely either at the hospital or at the doctor’s office. This means that you don’t necessarily need to be admitted to the hospital to get this done.
