Patient education is an integral component for patient compliance with dermatologic medical treatments. This column has been developed in partnership with the caring nurses dedicated to optimizing patient care through practicum-based education and treatment.
What is a biopsy?
Biopsies are very important procedures in dermatology to aid in determining a specific diagnosis. These office-based procedures can help diagnose questionable skin findings such as rashes, skin cancers, fungal or bacterial infections, chronic diseases such as psoriasis, and skin manifestations of internal cancers. Because there often are several distinct skin conditions with similar appearances but different treatment options, the information from a biopsy can help determine what further care may be needed.
How is a biopsy performed?
A biopsy is performed by using local anesthesia, most often lidocaine, in the area of the skin to be biopsied. There are different types of biopsies used for different areas of the skin, each with different techniques.
* Shave biopsies are the most widely used procedures in the office setting. They are also the least invasive because the provider can control the depth of the biopsy.
* Punch biopsies are generally performed to evaluate lesions that are concerning for deeper pathology, such as a rash of uncertain origin or to determine a malignancy. Unlike shave biopsies, punch biopsies take a sample of the entire depth of the skin. They are performed with a punch tool, a circular blade that resembles a cookie cutter.Most punch biopsies require closure with sutures.
* Excisional biopsies are generally performed for atypical moles or pigmented lesions to determine skin cancer such as melanoma. Similar to a punch biopsy, the entire depth of the skin is removed. However, in an excisional biopsy, a margin of surrounding skin can be taken as a precaution. Therefore, excisional biopsies are larger and require closure with sutures.
Skin Biopsy Postprocedure Wound Care Instructions
1. Keep the bandages or dressings on and dry for 24-48 hours.
2. Cleanse the biopsy site gently with soap and water daily.
3. Apply Vaseline and a dressing daily until healed.
4. Cover the site with a nonadherent pad.
5. Continue care for at least a week or until discontinued by your doctor or wound care provider.
Call your doctor if you have the following:
* Increasing redness, swelling, or pain in the area of the biopsy.
* Increasing drainage after 24 hours.
* Bleeding that does not stop after 20 minutes of continuous pressure.
* Any unexpected problems.
Special Considerations
* Patient will get a scar, which can be noticeable to very noticeable.
* Discomfort, swelling, and bruising are common and improve in several days.
* Adhesive products often cause localized mild redness or itching.
* Use of topical antibiotics has not been shown to speed healing or reduce infection and may cause an allergic response.
* Sutures are typically removed in 7-14 days depending on the location of the biopsy.
REFERENCES