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Which Type of Skin Biopsy Do I Need?

A skin biopsy is a procedure to diagnose various skin conditions. So whether you have an unusual patch of skin or a suspicious-looking mole, your doctor might have recommended a biopsy — and it’s normal to have questions.

Not all skin biopsies are created equal, and the best type for you depends on the suspected condition and the characteristics of the lesion. At Medical Associates Of North Texas, we offer convenient, comprehensive skin biopsies in our Fort Worth, Texas, office.

Three of the most common types of skin biopsies are shave, punch, and excisional biopsies — and here’s what you should know about which type might be right for you.

Shave biopsy

Shave biopsies are the least invasive technique, and they involve removing superficial lesions from the surface of your skin. We use a sharp blade or scalpel to shave off the top layers of your skin, including the suspicious lesion. 

Do you need a shave biopsy?

Shave biopsies are most often recommended to diagnose benign growths or superficial skin cancers. They’re ideal for superficial lesions confined to the top layers of the skin, such as actinic keratosis or seborrheic keratosis. 

In many cases, shave biopsies easily remove superficial lesions and provide enough tissue for accurate diagnosis without the need for stitches. They’re also a good option for cosmetically sensitive areas of your body, like your face or neck, because they typically result in minimal scarring.

Punch biopsy

Punch biopsy is a technique to obtain a deeper sample of skin tissue for examination. We use a circular blade to remove a small core of skin tissue, which can range from 2-6 millimeters in diameter.

Do you need a punch biopsy?

We may recommend a punch biopsy if you have a condition affecting deeper skin layers. For example, skin cancers like melanoma or basal cell carcinoma can extend into deeper layers of the skin, and a punch biopsy can provide a more accurate diagnosis. 

Punch biopsies are also effective for diagnosing inflammatory skin conditions like lupus, psoriasis, or granuloma annulare. These conditions often involve changes in multiple layers of skin, requiring a deeper tissue sample for accurate diagnosis.

Excisional biopsy

Excisional biopsies involve removing the entire lesion, along with a margin of surrounding healthy tissue. This is the most invasive option, and it may be the best choice for larger or irregularly shaped lesions, as well as suspected melanomas.

Do you need an excisional biopsy?

Large or irregularly shaped lesions sometimes can’t be adequately sampled with shave or punch biopsies. In these cases, you might need an excisional biopsy that removes the entire lesion to ensure all areas of concern are included in the biopsy specimen.

We may also recommend an excisional biopsy for suspected melanomas. Accurately assessing the lesion’s depth and margins is essential when diagnosing melanoma. Removing the entire lesion helps us obtain a comprehensive sample for accurate staging and treatment planning.

If you have a suspicious lesion on your skin, a biopsy might be the most effective way to get an accurate diagnosis. The type of skin biopsy you need depends on unique factors, and our team is here to help ensure you get the right care for your needs. Contact us online or call 972-433-7178 to learn more.

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