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Skin biopsy /Punch biopsy

A skin biopsy, or punch biopsy, is a bedside surgical procedure where your physician will use a small knife ‘puncher’ to obtain a small skin sample under local anaesthesia.
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Table of Contents

How does a skin biopsy work?

A skin biopsy, or punch biopsy, is a bedside surgical procedure where your physician will use a small knife ‘puncher’ to obtain a small skin sample under local anaesthesia. The surgical area will be closed with suture to promote healing.

Benefits

  • Skin biopsy is a useful procedure to obtain skin histological sample to aid clinical diagnosis and treatment.
  • It is an important procedure to rule out or confirm skin cancer in concerning skin lesions.
  • Safe
  • Minimal downtime

Who should go for a skin biopsy?

A skin biopsy is suitable for:

  • Irregular, poorly defined moles
  • Asymmetrical lesions
  • Ulcers, blisters that are poorly healed
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What results can I expect?

Skin biopsy results explain the microscopic findings in between the skin layers. It is immensely insightful in explaining the causes of the skin condition ranging from inflammatory, autoimmune to cancer causes. With this, skin biopsy result can tailor the treatment of skin condition

How many sessions needed?

1 session is required for skin biopsy procedure. You will have a follow up session 1-2 weeks later to review the biopsy site and removal of sutures.

FAQ

Do I need to prepare/ fast prior to procedure?

No fasting is required. You are advised to inform your doctor on your past medical histories and medication that you are taking.

What is the benefits of skin punch biopsy?
Skin punch biopsy obtains a piece of skin tissue, allowing the tissue to be examined under microscope. The understanding of the microscopic findings of a skin lesion helps clinician to diagnose and guide treatment of skin conditions. Skin punch biopsy is useful especially in complex skin conditions that have failed various topical or oral treatment. It is also useful to pick up skin cancers, skin infection, or autoimmune skin conditions.
What can skin punch biopsy detect?
Skin punch biopsy is able to detect or rule out certain skin cancer, skin infection, blistering skin conditions and inflammatory skin conditions.
How long do I have to wait to get the results of a skin punch biopsy?
The biopsy results turnover is usually 1 to 2 weeks. The biopsy skin sample will have to be stained and placed under microscopy before a pathologist is able to interprete it.
Will I have a scar after skin punch biopsy?

The skin punch biopsy site is usually closed with a suture to promote healing. Over time the biopsy site will heal with a neat vertical line.

Is skin punch biopsy painful?
The procedure is generally well-tolerated among patients. Your doctor will guide you through the procedure. After marking and confirming the skin area of concerned, local anaesthetic medication will be given to numb the region. The biopsy procedure will only be carried out once the area is numbed. After the procedure, you may feel slight discomfort over the biopsy site. Most patients are able to manage the pain with simple analgesia such as paracetamol.
Do I need to take time off after the procedure, how long does it take to heal?
You can return to work or your daily routine after the procedure if you wish to. We usually advise you to take the day/week easy after the procedure. You should avoid excessive workout, sweating, soaking skin wound region in tubs, hot baths or swimming for 1 week. The wound usually takes 1-2 weeks for healing. Your doctor or nurse will guide you on how to look after the wound.
Is skin punch biopsy procedure risky, serious?
Although it is a skin surgical procedure, it is relatively safe. The common risks of the procedures include bleeding, infection, injury to the surrounding tissues and scarring due to the procedure. Your doctor will obtain your medical histories and discuss with you the risks involve prior to the procedure.
How accurate is a punch biopsy?
If the skin punch biopsy sample is not able to obtain the entire abnormal skin lesion, the diagnosis yield can be low, and sometimes, diagnosis can be missed. You are advised to discuss with your doctor before the procedure on the accuracy and sensitivity of the tests in your skin condition.
Can a punch biopsy remove all cancerous tissue?
This will depend on individual skin lesion (the size and depth of the lesion). In small skin lesions, the punch knife may be able to remove the whole lesions. In bigger skin lesions, occasionally after interpreting the biopsy results, your doctor may advise you for further excision or removal of the whole affected skin tissue.
How do I take care of a skin punch biopsy wound?
You will be taught how to look after your wound prior being discharged from the clinic. You can clean the biopsy wound site daily with normal saline, and apply topical antibiotic cream. Depending on your individual risks, your doctor may also prescribe you oral antibiotics to prevent secondary bacterial infection from the wound. You are advised to avoid excessive sweating/exercise, avoid long baths or swimming for a week after the procedure. You will usually be given a follow up in in 1-2 weeks time to review the wound site by your physician, and removal of stitches (if required).
What should I avoid doing after punch biopsy?
You should keep the wound site clean and dry. Avoid sticky bandages. To keep the wound site clean, your doctor will advise you to avoid excessive sweating, hot long baths, or swimming after procedure.
Is a skin punch biopsy a surgery?
Skin punch biopsy can be done in a clinical setting/ treatment room, as long as the equipment are sterile. It is a skin procedure that is performed under local anaesthesia. The procedure usually takes about 15-30 minutes depending on the complexity of the case.

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