Skin Biopsy

WHAT IS SKIN BIOPSY?

A skin biopsy is a diagnosis performed by cutting out a small portion of the human skin to test for cancers and diseases associated with the skin. The skin samples gotten are examined with the aid of a microscope. This test aids with easy analysis of perplexities concerned with the skin. 

According to research, not all skin biopsies conducted produces a conclusive result and not all dermatologist conduct this skin biopsy to all patients consulted.

WHY IS IT DONE?

People tend to have a rash or even a mole on the skin thereby, consulting a dermatologist to deduct the causes and make a diagnosis. To this effect, a skin biopsy is recommended.

The skin biopsy is a method established to verify a diagnosis that occurs on the skin as it is the means of determining how severe the infection or cancer is.  A skin biopsy aids confirmation of conditions like eczema, melanoma, rash, or any other skin-related diseases. It is performed to discover the features of irregular growths present in the skin.

TYPES OF SKIN BIOPSY/ PROCESS

There are four basic ways of conducting the skin biopsy but selecting the one to use depends mainly on the following criteria; anesthesia and consent of the patient. Also, the position of the injury, the size, and the depth are prerequisites for the determination of the type of skin biopsy to use. These types are explained below:

• Shave Biopsy

The shave biopsy originates from the usage of the blade. This biopsy process involves the use of either a razor blade or a scalpel blade and the specialist must be grounded with adequate skills as it is a prerequisite for a minimal spot on the patient’s skin. 

Most times, razors are used due to the little blemish observed after taking the sample from the skin. Little bleeding might occur for the shave biopsy but hemostasis is used though it might not be fully effective. 

The hemostasis makes use of a light electrocautery process but is not fully effective if used alone as it can result in a burn on the skin. Pressure dressing aids the hemostasis process.

• Punch Biopsy

The punch biopsy involves the use of a circular object which is like the shape of a pen with a blade attached to the bottom which is placed on the skin and rotated to extract a circular-shaped tissue sample from the skin. 

The injury from the punch biopsy can easily be sutured to stop bleeding. The diameter of the punch for the punch biopsy ranges in sizes from 1mm to 4mm. 

In some cases, the 1mm or 1.5mm are utilized where the shave biopsy process can not be used and the bleeding is minimal with fast recovery even without suturing. But this has constraints of resulting in tiny tissue extraction limiting the dermatologist to few information after the examination. Though, the size used in most of the punch biopsy is 3.5 to 4 mm.

• Incisional Biopsy

The incisional biopsy is similar to the punch biopsy with little disparity in the shape of the blade and mode of the incision. In the incisional biopsy, the blade is round compared to the elliptical punch and the cut goes straight to the subcutaneous tissue with the aid of a scalpel. 

The size of the lesion to be taken as the sample depends on the skin problem. It can be a small fraction, the affected area, or even the affected with the normal skin.

Due to the depth of the incision made, the output tends to be outstanding for deeper skin problems. Therefore, incisional biopsy is the best for diagnosis on deeper skin disorders as it permits the extraction of the large sample that is good enough for an examination compared to the shave or even punch biopsy. 

The incision biopsy is advantageous to the punch biopsy concerning the hemostasis as an adequate visual to the blemish is poisoned.

• Excisional Biopsy

The excisional biopsy is also similar to the incisional biopsy. Though the excisional biopsy is more precise as the whole lesion is removed but the lesion must be small. This is used in diagnosing disorders like melanoma.

For the excision, a little surgical margin is used to ensure the thickest part of the melanoma is extracted. Before opting for the excisional biopsy, the punch biopsy is recommended for the melanoma before further recommendations for the excision.

ELIGIBILITY

Patients with a history of anesthesia problems should be noted as a pre-examination biopsy will be performed by the specialist. 

Also, patients with the issue of bleeding even after any surgery or medical procedure alongside drug effects must follow the prescriptions of the doctor as those factors may affect hemostasis.

Other than that anyone is eligible for the skin biopsy as far as the patient has a skin disorder and needs to be diagnosed for treatments.

PREPARATION

There are no specific measures to be taken in preparation for the skin biopsy, when a skin problem is detected, the specialist is consulted and the risks involved in the skin biopsy will be related to the patient and the date will be set for the test.

PROCEDURE 

The process involved in the skin biopsy are outlined below:

• Before the Test

The skin is prepared by rubbing povidone or alcohol solution to cleanse the region to which the tissue sample will be removed from. Then anesthesia will be administered to the patient to numb the area where the samples will be taken from.

• During the Test

Either of the types of skin biopsy is used based on the type of skin problem to be diagnosed. After removal, the sample is placed in a container with the presence of fixative in the container before delivered to the specialist for an examination.

• After the Test

After the skin biopsy has been performed, the affected area should be treated properly to avoid blood leakage and Tylenol is mostly applied to facilitate fast recovery. The healing rate may take 2 to 3 weeks.

DURATION

The duration of the skin biopsy depends on the type of skin biopsy used while the test takes about one to two weeks after excessive research for the conclusions to be deducted. 

RESULT

The skin biopsy indicates the stages, type, and size of irregular growths present on the skin like melanoma, carcinoma, and other skin disorders. 

These discoveries can provide the dermatologist a diagnosis and hence the knowledge of a treatment plan for facilitating the recovery of the patient.

RISKS

The following complications might occur after undergoing the skin biopsy:

1. Bleeding.
2. Hematoma.
3. Hypertension.
4. Presence of vesicles.
5. Infection.
6. Presence of erythema.

If any of these complications are present, it is advisable to report to the specialist immediately for recommendations and prescriptions.

SPECIALTY

A dermatologist is known to be the doctor of the skin thereby being the specialist, though, a pathologist or a dermatopathologist can also conduct this test.

COST

The cost of the skin biopsy ranges from $100 to $300 in the U.S and may cost d8fferently in other countries or vary according to the hospital. The cost also depends on the location of the lesion to be removed and the complexity of the skin.

FAQs

• What is the accuracy of the skin biopsy?

The skin biopsy has an accuracy rate of 83% making it effective than another method for diagnosing a skin disorder or infection.

• Does a skin biopsy mean skin cancer?

The skin biopsy does not mean a skin cancer, but it can be used to detect a possible skin defect that can be treated after discovery.

• Is the skin biopsy process painful?

Before the test is done, anesthesia is always administered to numb all pains even when the tissue sample is extracted from the skin. Therefore, the process is not painful, just a sting felt when trying to inject the anesthesia.

• Which type of skin biopsy is the most effective?

The skin biopsy to be used varies depending on the possible type of skin defect. For just surface infections, the punch biopsy is the best method to use but when the infections go deeper into the skin, the incision is the best as better conclusions can be deducted.

• What percentage of skin biopsy is skin cancer?

According to research, it can be concluded that the skin cancer found in the skin biopsy has an average of 44.5%.

• Does it need to be done more than once?

No, the skin biopsy just needs to be done once as the tissue sample got is adequate to provide in-depth information about the skin disorder.