A skin biopsy is a widely utilised diagnostic procedure entailing carefully removing or excising a portion of skin tissue from the patient’s body and evaluating it in the laboratory. This assay helps in detecting chronic skin disorders such as psoriasis, actinic keratosis and even confirming the occurrence of skin cancers such as basal cell carcinoma and melanoma.
Also Read: Melanoma: Causes, Symptoms And Treatment
Types Of Skin Biopsy:
There are three primary forms of skin biopsy protocols, namely, shave biopsy, punch biopsy and excisional biopsy. These techniques are performed by a doctor or trained nurse in a clinic or hospital under sterile settings to prevent contamination of the patient’s skin tissue sample.
Shave Biopsy:
In this protocol, the doctor utilises a medical instrument closely resembling a razor, to eliminate a minor segment of the epidermis and dermis – the layers of the skin which lie on the exterior surface.
Punch Biopsy:
Here, a circular device is rotated to pierce into the deeper portions of the skin, so as to enable the physician to collect a small-sized sample of the epidermis, dermis and superficial fat divisions of the patient’s dermal tissues.
Excisional Biopsy:
A tiny knife-like apparatus termed a scalpel is made use of in excisional biopsy. Using this, the medical professional precisely cuts off the whole part of an unusual lump or skin region along with a fraction of normal tissue, which sometimes consists of the fatty section of the skin as well.
Why It Is Done:
The chief purpose of a skin biopsy is to identify signs of skin disorders and aid in their early diagnosis to ensure timely treatment of any infection or ailment. The procedure is very useful in determining various skin-related conditions such as:
- Skin issues linked with inflammation - psoriasis, eczema, rosacea
- Maladies that exhibit prominent blisters on the skin, like bullous pemphigoid
- Actinic keratosis, that presents as deep red skin lesions from severe sun damage
- Infections in the skin that occur with rashes, itching and swelling
- The sudden or aberrant appearance of moles, other odd growths on the skin
- Skin bumps that arise from viruses such as warts
- Skin cancer, comprising different types like melanoma, squamous cell carcinoma and basal cell carcinoma
Also Read: Basal Cell Carcinoma: Causes, Symptoms And Treatment
Procedure:
Prior to the skin biopsy, the patient is assessed by the doctor to know if they have any pre-existing illnesses or health anomalies that may hamper the skin biopsy process. These include allergic reactions to local anaesthetics, topical antibiotic medications, a blood-related disorder that affects clotting or triggers undue bleeding and even a medical history of contagious skin infections like impetigo. Additionally, the healthcare provider enquires if the patient is on any blood-thinning medications, any other prescription drugs/supplements, to make sure that they do not induce uncontrolled bleeding post the biopsy.
Based on which part of the skin tissue the doctor is going to collect, the patient can either don their own clothes or be requested to wear a hospital gown if tissues from the back, torso, buttocks or thighs need to be excised. Using a sterilisation liquid, the doctor or nurse wipes the area of skin tissue and makes sure it is completely clean of any dust, dirt or debris. An outline of the area to be removed for the biopsy is then sketched out prominently. A medication to numb the skin area from painful sensations known as a local anaesthetic is then injected via a thin needle, which initially triggers a minor burning feeling that subsides quickly. Then the skin biopsy procedure is performed, employing shave, punch or excisional techniques by the doctor or nurse, the sample tissue is collected in a sanitised container and later studied in the lab under a microscope and using other protocols and equipment.
The entire procedure of a skin biopsy generally takes 15 minutes and the region of skin that was punctured is bandaged, following which the patient can resume normal day-to-day activities. The doctor instructs the patient to leave the bandage on for 1 – 2 days and after removing it fully, rinse and clean the site of excision twice a day for up to 1 week until the tissue heals and renews completely. Furthermore, the patient is advised not to perform any intense exercise or stretching activities that could lead to tearing of tissues at the site of the skin biopsy.
Risks:
In most instances, a skin biopsy is a safe procedure that does not cause much pain, discomfort or lead to any grave health problems. However, at times, slight complications can develop at the site of excision and the neighbouring skin tissues, which consist of:
- Tissue wounds and bruising
- Bleeding due to insertion of medical tools with sharp edges
- Formation of subtle scars
- Infection and inflammation in the area of perforation
Results:
The skin tissue samples of the patient are examined in the laboratory and the results are available after a few days or may take longer up to 1 -2 weeks if the medical professional needs to investigate them for more dermatological conditions.
Depending on what kind of skin ailment is detected, the doctor advises the patient on the appropriate course of treatment. If the results indicate a form of skin cancer, the physician suggests advanced therapy to treat and manage the same and prevent recurrence of the illness.
Frequently Asked Questions
Does A Skin Biopsy Hurt?
Patients may feel a slight pinch or discomfort during the administration of local anaesthesia. However, once the area is numbed, the biopsy is generally painless. Mild soreness or discomfort may be experienced afterwards.
Are There Risks Associated With Skin Biopsies?
While skin biopsies are generally safe, potential risks include infection, bleeding, scarring, or an allergic reaction to anaesthesia. These risks are minimal, and healthcare professionals take precautions to minimize them.
Can All Skin Conditions Be Diagnosed With A Biopsy?
While skin biopsies are valuable diagnostic tools, not all skin conditions require biopsy. Dermatologists use their expertise to determine when a biopsy is necessary, often considering factors such as the appearance of the lesion, medical history, and risk factors.
Will There Be A Visible Scar After A Skin Biopsy?
The size and location of the biopsy, as well as individual healing factors, influence scarring. In many cases, scars are minimal and fade over time. Dermatologists prioritize techniques that minimise scarring whenever possible.
What Happens After A Skin Biopsy?
After the biopsy, the site may be covered with a bandage. It's essential to follow post-care instructions, including keeping the area clean, avoiding certain activities, and monitoring for signs of infection.
References:
- Techniques of Skin Biopsy and Practical Considerations - By Urmila Nischal,1 Nischal KC,2 and Uday Khopkar3
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840913/
- Biopsy Techniques for Skin Disease and Skin Cancer: A New Approach - By Azize Kilic, Ali Kilic,1 Ali E. Kivanc,1 and Abdullah Sisik1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646420/
