Skin Biopsy
Reviewed
Also called: punch biopsy, shave biopsy, excisional biopsy, skin cancer biopsy
A skin biopsy is a procedure that removes a small sample of skin to be examined under a microscope. It helps diagnose skin conditions such as infections, disorders like psoriasis, and skin cancer (basal cell carcinoma, squamous cell carcinoma, melanoma). The type of biopsy (punch, shave, or excisional) depends on the size and location of the abnormal skin area.
Specimen: skin tissue sample
Why this test may be ordered
- Persistent rash
- Scaly or rough skin
- Open sores that won't heal
- Blistering skin (possible autoimmune disease)
- Mole or growth with ABCDE signs of melanoma (Asymmetry, irregular Border, uneven Color, Diameter > pea, Evolving)
Preparation and collection
No special preparation is needed.
A healthcare provider cleans the site and injects a local anesthetic. The specific steps depend on the biopsy type: punch biopsy uses a circular tool to remove a small core; shave biopsy uses a razor to remove top skin layers; excisional biopsy uses a scalpel to remove the entire lesion. Stitches may be needed for punch or excisional biopsies. The site is bandaged.
You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or get worse, talk to your provider.
Understanding results
A pathologist examines the skin sample under a microscope. Your healthcare provider will discuss the results with you and explain what they mean for your health.
- Normal: No cancer or skin disease was found. Limitation: A normal result does not rule out all skin conditions. If symptoms persist, follow up with your provider. Next step: Routine follow-up as recommended by your healthcare provider.
- Abnormal – Non‑melanoma skin cancer (basal cell or squamous cell carcinoma): The biopsy shows a type of skin cancer that rarely spreads. The entire cancerous lesion may have been removed during the biopsy or can be removed soon after. Limitation: This result is based on the sample taken; additional treatment may be needed if the lesion was not completely removed. Next step: Often no further treatment is needed. Your provider will confirm if any follow‑up is necessary.
- Abnormal – Melanoma: The biopsy shows melanoma, a more serious type of skin cancer that can spread. Limitation: This result does not indicate whether the cancer has spread. Additional tests are required to determine the stage. Next step: You will need more tests to see if the cancer has spread. Then you and your provider can develop a treatment plan.
- Abnormal – Infection or skin disorder (e.g., bacterial/fungal infection, psoriasis): The biopsy shows signs of an infection or a non‑cancerous skin condition. Limitation: The specific diagnosis depends on the microscopic findings. Further evaluation may be needed to identify the exact cause. Next step: Discuss the results with your healthcare provider for appropriate treatment or management.
- A skin biopsy is a procedure, not a laboratory test. The sample is sent to a pathology laboratory for analysis.
- Interpretation of results should be done by a healthcare professional. No reference ranges or units are provided for this test.
- The biopsy may not capture the entire lesion if only a sample is taken; an excisional biopsy removes the whole lesion.
What to do next
Your healthcare provider will explain your specific results and recommend any necessary follow‑up, treatment, or additional testing.
- What type of skin biopsy did I have?
- When will I get my results?
- What do my results mean for my health?
- Do I need any further tests or treatment?
- How should I care for the biopsy site?