What is a Skin Biopsy?

Skin biopsy is a clinical laboratory test in which a small amount of skin tissue is extracted by a dermatologist and viewed microscopically. Skin biopsy method is applied to the diagnosis evaluation of certain skin illnesses like infection, inflammatory illness, and skin cancer. The most frequent use by the patient of the skin biopsy is to identify skin cell abnormality that cannot be identified through the naked eye.

A physician, therefore, uses special instruments to excise a patch of skin. The tissue is analyzed and subjected to tests by a pathologist for the possible ability to detect disease or abnormality. Skin biopsies are performed in secure and comfortable outpatient-based clinic settings.

Why a Skin Biopsy Would Be Done?

Why skin biopsy is done by dermatologists due to the following reasons:

  • Skin Cancer Diagnosis: To exclude or diagnose skin cancers such as melanoma, squamous cell carcinoma, or basal cell carcinoma.
  • Skin Lesion Examination: For examination of moles, warts, or other irregular lesions.
  • Detection of Infection: To detect bacterial, viral, or fungal infections on the skin surface.
  • Measurement of Inflammatory Disease: To diagnose inflammatory conditions such as lupus, eczema, or psoriasis.
  • Diagnosis of Rash: For the diagnosis of the underlying cause of the long-standing or cryptic rash.
Through the examination of skin tissues, the doctors can diagnose and proceed with appropriate treatment procedures.

Preparation of Skin Biopsy

Skin biopsy preparation is simple:

  • Tell Your Doctor: Let your doctor know if you take any medications, especially blood thinners like aspirin or warfarin, that increase your risk of bleeding.
  • Avoid: Do not apply creams, lotions, or make-up to unbiosied skin on the day of the biopsy.
  • Dress in comfort: Loose and comfortable clothes that won't chafe over the biopsy area.
  • Wear: Inform your doctor if there's a known allergy, especially local anesthetic or antiseptics.
  • No fasting is necessary: Nothing by mouth, fluids, or anything else unless directed.
By accomplishing all these, the procedure is uneventful without complication and the chances of complications are reduced.

Skin Biopsy Procedure

Skin biopsy procedure is a brief procedure overall and includes the following:

  • Area Sterilization: Antiseptic solution is applied over the infected skin area so that it will not become infected.
  • Administration of Anesthesia: A local anesthetic is administered so that the area will become numb and no part of pain is felt when performing it.
  • Removal of Tissue Sample: Depending on what the lesion type is, the doctor will remove one of the following discussed biopsies:
  • Shave Biopsy: Removal of a skin's top layer, most useful in elevating lesions.
  • Punch Biopsy: Using a cylindrical instrument to shave off a patch of skin in a cylindrical shape, most useful in diagnosis of rash or inflammation.
  • Excisional Biopsy: Complete removal of the lesion or infected tissue, typically a presumed skin cancer case.
  • Bleeding Control: Pressure to control any bleeding and, in some cases, there will be a chemical or electrical agent used.
  • Wound Closure: Suturing or spontaneous wound closure based on biopsy size and type.
  • Banding of the Wound: Wound covering to protect against infection.
The entire process would take 15 to 30 minutes, and same-day discharge is reserved for patients.


What to Expect After the Skin Biopsy?

After the procedure, redness, swelling, or tenderness in the area that was biopsied can be expected. The following are What to expect after skin biopsy:

  • Pain Relief: Mild soreness or tenderness is eased by over-the-counter medication such as acetaminophen.
  • Wound Care: Dry and keep clean. Remove all dressings and apply ointment as your doctor has instructed.
  • Activity Limitation: Do not lift, bend, or do strenuous activity that tugs at the area where the biopsy was performed until it heals.
  • Infection Monitoring: Check for swelling, redness, pus, or fever and report to your doctor.
Skin biopsy healing time will vary depending on the Types of skin biopsy and individual factors. Shave biopsies take a week to heal, while punch or Excisional skin biopsy take two or three weeks to heal.

Interpreting Skin Biopsy Results

Lab tissue is examined in the lab and lab reports within a week or two. Reports may show Skin biopsy results:

  • Normal: No cancer cells are seen, i.e., normal skin tissue.
  • Benign: Benign growth such as wart or mole.
  • Malignant: There are malignant cancer cells that require treatment or surgery.
  • Inconclusive: Additional tests are ordered if report is inconclusive.
Your doctor will tell you the result and what you have to do, treatment, further tests, or follow-up.

Diseases Diagnosed by Skin Biopsy

All diseases are diagnosed through skin biopsies

  • Skin Cancers: Basal cell carcinoma, squamous cell carcinoma, and melanoma.
  • Inflammatory Dermatoses: Psoriasis, eczema, and dermatitis.
  • Infectious Diseases: Fungal infection, bacterial infection, and viral warts.
  • Autoimmune Disorders: Such as pemphigus and lupus.
  • Benign Skin Tissue Tumours: Such as cysts, lipomas, and moles.
The biopsy is for accurate diagnosis in preparation for effective and successful treatment procedures.

Punch Biopsy and Skin Biopsy

Shave biopsy and punch biopsy are diagnostic procedures for skin lesions but of different technique, use, and depth.

Shave Biopsy:

  • Only trains the superficial skin layers (epidermis and a superficial level of dermis).
  • Used mostly on uncolored lesions or small raised lesions.
  • Can be done relatively fast without sutures.
  • Less scarring and faster recovery.

Punch Biopsy:

  • Removed by making a small round full-thickness skin core by cutting it out with a punch instrument.
  • To diagnose other underlying conditions such as infection, rashes, or autoimmune disease.
  • On average, one or two stitches will be enough to close the wound.
  • Would take longer to heal and may produce more visible scarring.

The technique of the two differs with the nature of the character, lesion size, and need for diagnosis. The patient is clinicially diagnosed by the dermatologist and the most appropriate method of Dermatologist skin biopsy is prescribed to make a proper diagnosis.


Cost of Skin Biopsy in Pakistan

Skin biopsy cost in Pakistan differs in the form of biopsy, clinic, and location. On average:

  • Shave Biopsy: PKR 3,000 to PKR 5,000.
  • Punch Biopsy: PKR 4,000 to PKR 6,500.
  • Excisional Biopsy: PKR 5,000 to 10,000.
  • Add Laboratory Test: PKR 2,000 to 4,000.
Price will vary and it would be better to ask for an on-the-spot quotation from the local hospitals or clinics.

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